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[Perimesencephalic hemorrhage].

P Canhão1, A N Pinto, T Pinho e Melo

  • 1Serviço de Neurologia, Neurocirurgia e Radiologia, Hospital Santa Maria, Lisboa.

Acta Medica Portuguesa
|October 1, 1992
PubMed
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Perimesencephalic hemorrhage, a type of subarachnoid hemorrhage, typically presents with sudden headache and benign outcomes. Patients with normal initial cerebral angiography may not require repeat imaging, simplifying diagnosis and management.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Context:

  • Subarachnoid hemorrhage (SAH) diagnosis and management.
  • Evaluation of patients with normal cerebral angiography.
  • Characterization of perimesencephalic hemorrhage (PMH).

Purpose:

  • To identify patients with perimesencephalic hemorrhage (PMH) among those with subarachnoid hemorrhage (SAH).
  • To describe the clinical presentation and radiological findings of PMH.
  • To assess the outcomes and need for repeat angiography in PMH.

Summary:

  • Out of 293 SAH patients, 108 had normal cerebral angiography.
  • Twenty-three patients met radiological criteria for PMH.
  • PMH patients presented with severe headache, meningeal signs, and no focal deficits or decreased alertness.

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  • The evolution was benign with no mortality, morbidity, or rebleeds over 3.5 years.
  • Impact:

    • Suggests that repeat angiography may not be necessary for subarachnoid hemorrhage patients with normal initial findings suggestive of PMH.
    • Highlights the benign nature and favorable prognosis of perimesencephalic hemorrhage.
    • Aids in streamlining diagnostic pathways for specific SAH subtypes.