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Related Experiment Videos

Diffuse vasospasm after pretruncal nonaneurysmal subarachnoid hemorrhage.

W I Schievink1, E F Wijdicks, R F Spetzler

  • 1Cedars-Sinai Neurosurgical Institute, Los Angeles, CA, USA.

AJNR. American Journal of Neuroradiology
|March 24, 2000
PubMed
Summary

Pretruncal nonaneurysmal hemorrhage can present with severe vasospasm, challenging its benign classification. This finding expands the clinical spectrum of subarachnoid hemorrhage, indicating vasospasm does not rule out this diagnosis.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Pretruncal (perimesencephalic) nonaneurysmal hemorrhage is typically considered a benign form of subarachnoid hemorrhage (SAH).
  • Angiographic vasospasm is uncommonly observed in these cases and is usually mild and focal when present.

Observation:

  • This report details two patients with pretruncal nonaneurysmal SAH who experienced severe and diffuse vasospasm.
  • The first patient, a 40-year-old woman, developed diffuse vasospasm affecting both anterior and posterior circulation on day seven post-hemorrhage.
  • The second patient, a 67-year-old woman, showed severe anterior and moderate posterior circulation vasospasm on day nine, with subsequent transient dysphasia.

Findings:

  • The presence of severe and diffuse vasospasm was observed in two cases of pretruncal nonaneurysmal SAH.

Related Experiment Videos

  • Both patients were successfully treated with hypervolemia, with resolution of vasospasm in the first case and normalization of blood velocities in the second.
  • These cases demonstrate that severe vasospasm can occur in pretruncal nonaneurysmal SAH, expanding its known clinical presentation.

    • Implications:

    • The findings suggest that severe and diffuse vasospasm does not exclude the diagnosis of pretruncal nonaneurysmal SAH.
    • This expands the clinical and radiological spectrum of this condition, potentially altering diagnostic and management strategies.
    • Further research may be warranted to understand the mechanisms and optimal management of vasospasm in this specific SAH subtype.