BACKGROUND: Nonaneurysmal perimesencephalic subarachnoid hemorrhage (SAH) has usually a benign prognosis and uneventful course; however, recent reports suggest that these patients may develop severe symptomatic vasospasm. METHODS: Description of the clinical course of one patient with nonaneurysmal perimesencephalic SAH who required intraarterial infusion of calcium antagonists and transluminal balloon angioplasty for treatment of symptomatic vasospasm. The perimesencephalic clot burden was quantified to determine if there is a relationship with the development of symptomatic vasospasm. RESULTS: Despite maximized clinical management, the patient described in this report developed vasospasm and delayed cerebral ischemia (DCI), requiring multiple endovascular interventions. The volumetric quantification of subarachnoid blood was 15.4 ml, and was mostly localized in the cisternal space. CONCLUSIONS: Nonaneurysmal perimesencephalic SAH may have a "malignant" course requiring close neurocritical care monitoring and multiple clinical and endovascular interventions. Moreover, large cisternal hemorrhage was correlated with the development of DCI in this patient with non-aneurysmal SAH.
BACKGROUND:Nonaneurysmal perimesencephalic subarachnoid hemorrhage (SAH) has usually a benign prognosis and uneventful course; however, recent reports suggest that these patients may develop severe symptomatic vasospasm. METHODS: Description of the clinical course of one patient with nonaneurysmal perimesencephalic SAH who required intraarterial infusion of calcium antagonists and transluminal balloon angioplasty for treatment of symptomatic vasospasm. The perimesencephalic clot burden was quantified to determine if there is a relationship with the development of symptomatic vasospasm. RESULTS: Despite maximized clinical management, the patient described in this report developed vasospasm and delayed cerebral ischemia (DCI), requiring multiple endovascular interventions. The volumetric quantification of subarachnoid blood was 15.4 ml, and was mostly localized in the cisternal space. CONCLUSIONS:Nonaneurysmal perimesencephalic SAH may have a "malignant" course requiring close neurocritical care monitoring and multiple clinical and endovascular interventions. Moreover, large cisternal hemorrhage was correlated with the development of DCI in this patient with non-aneurysmalSAH.
Authors: Andrei V Alexandrov; Michael A Sloan; Charles H Tegeler; David N Newell; Alan Lumsden; Zsolt Garami; Christopher R Levy; Lawrence K S Wong; Colleen Douville; Manfred Kaps; Georgios Tsivgoulis Journal: J Neuroimaging Date: 2010-10-26 Impact factor: 2.486
Authors: Sang-Bae Ko; H Alex Choi; Amanda Mary Carpenter; Raimund Helbok; J Michael Schmidt; Neeraj Badjatia; Jan Claassen; E Sander Connolly; Stephan A Mayer; Kiwon Lee Journal: Stroke Date: 2011-01-21 Impact factor: 7.914
Authors: Marike Zwienenberg-Lee; Jonathan Hartman; Nancy Rudisill; Lori Kennedy Madden; Karen Smith; Joseph Eskridge; David Newell; Bon Verweij; M Ross Bullock; Andrew Baker; William Coplin; Robert Mericle; Jian Dai; David Rocke; J Paul Muizelaar Journal: Stroke Date: 2008-04-17 Impact factor: 7.914
Authors: Matthew L Flaherty; Mary Haverbusch; Brett Kissela; Dawn Kleindorfer; Alexander Schneider; Padmini Sekar; Charles J Moomaw; Laura Sauerbeck; Joseph P Broderick; Daniel Woo Journal: J Stroke Cerebrovasc Dis Date: 2005 Nov-Dec Impact factor: 2.136
Authors: Jonathan A Friedman; Stephan J Goerss; Fredric B Meyer; David G Piepgras; Mark A Pichelmann; Jon I McIver; L Gerard Toussaint; Robyn L McClelland; Douglas A Nichols; John L D Atkinson; Eelco F M Wijdicks Journal: J Neurosurg Date: 2002-08 Impact factor: 5.115
Authors: Ning Lin; Georgios Zenonos; Albert H Kim; Stephen V Nalbach; Rose Du; Kai U Frerichs; Robert M Friedlander; William B Gormley Journal: Neurocrit Care Date: 2012-06 Impact factor: 3.210
Authors: A Ringelstein; O Mueller; S L Goericke; C Moenninghoff; U Sure; I Wanke; M Forsting; M Schlamann Journal: Clin Neuroradiol Date: 2013-11-28 Impact factor: 3.649
Authors: A Ringelstein; O Mueller; O Timochenko; C Moenninghoff; U Sure; M Forsting; M Schlamann Journal: Nervenarzt Date: 2013-06 Impact factor: 1.214