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Related Concept Videos

Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
Esophageal Varices-I: Introduction01:24

Esophageal Varices-I: Introduction

Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
Stroke: Introduction and Types01:29

Stroke: Introduction and Types

A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...

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Related Experiment Video

Updated: Jun 4, 2026

Endovascular Perforation Model for Subarachnoid Hemorrhage Combined with Magnetic Resonance Imaging (MRI)
06:30

Endovascular Perforation Model for Subarachnoid Hemorrhage Combined with Magnetic Resonance Imaging (MRI)

Published on: December 16, 2021

Perimesencephalic hemorrhage and vessel variants.

I Pechlivanis1, F Shang, A Harders

  • 1Ruhr-University of Bochum, Department of Neurosurgery, Bochum, Germany. ioannis.pechlivanis@umm.de

Central European Neurosurgery
|February 24, 2011
PubMed
Summary

Patients with perimesencephalic subarachnoid hemorrhage (PMSAH) show more frequent vertebro-basilar arterial variations. CT angiography (CTA) is sufficient for diagnosing PMSAH, avoiding further invasive procedures.

Related Experiment Videos

Last Updated: Jun 4, 2026

Endovascular Perforation Model for Subarachnoid Hemorrhage Combined with Magnetic Resonance Imaging (MRI)
06:30

Endovascular Perforation Model for Subarachnoid Hemorrhage Combined with Magnetic Resonance Imaging (MRI)

Published on: December 16, 2021

Area of Science:

  • Neurology
  • Radiology
  • Vascular Medicine

Background:

  • Perimesencephalic subarachnoid hemorrhage (PMSAH) often presents with normal computed tomography (CT) scans and a favorable prognosis.
  • Intracranial aneurysms are typically the cause of subarachnoid hemorrhage (SAH), but are often undetected in PMSAH cases.
  • Vessel variants in the vertebro-basilar circulation may be associated with PMSAH.

Purpose of the Study:

  • To assess the prevalence of vertebro-basilar circulation variants in PMSAH patients compared to SAH patients with aneurysms.
  • To determine if CT angiography (CTA) alone is sufficient for diagnosing PMSAH.

Main Methods:

  • Retrospective analysis of CTA and digital subtraction angiography (DSA) data from 28 PMSAH patients (study group).
  • Comparison of vessel diameters and variants in the posterior circulation between PMSAH patients and 28 control patients with aneurysmal SAH.
  • Evaluation of CTA findings against DSA results for diagnostic sufficiency.

Main Results:

  • 92.9% of PMSAH patients exhibited arterial vessel hypoplasia, significantly higher than the 60.7% in the control group (p=0.010).
  • Aplasia of a vessel occurred more frequently in PMSAH patients (53.6%) versus controls (21.4%; p=0.026).
  • No vessel variants were observed in 8 control patients, compared to none in the PMSAH group (p=0.004).

Conclusions:

  • PMSAH is associated with a significantly increased incidence of arterial vessel hypoplasia.
  • CTA is a sufficient diagnostic tool for typical PMSAH, rendering DSA unnecessary in many cases.