Lower extremity monoparesis after aneurysmal subarachnoid hemorrhage

Area of Science:

• Neurology
• Neurosurgery
• Vascular Neurology

Background:

• Acute subarachnoid hemorrhage (SAH) is a critical neurological emergency.
• Ruptured intracranial aneurysms are a common cause of SAH.
• Endovascular coil embolization is a standard treatment for intracranial aneurysms.

Observation:

• Two patients treated for ruptured intracranial aneurysms developed delayed lower extremity monoparesis.
• The monoparesis was painless and resolved spontaneously over several months.
• No other neurological symptoms were associated with the monoparesis.

Findings:

• Extensive investigations were performed to determine the cause of the monoparesis.
• The leading hypothesis is peripheral neuropathy resulting from nerve root irritation.
• Irritation is attributed to the presence of abundant subarachnoid blood in the lumbar cistern.

Implications:

• This finding suggests a potential complication of subarachnoid hemorrhage treatment.
• Understanding this mechanism may improve patient monitoring and management strategies.
• Further research is warranted to confirm this hypothesis and its prevalence.