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Related Experiment Videos

"Vasospasm Mimic" After Aneurysmal Subarachnoid Hemorrhage.

Thomas Ritzenthaler1, Florent Gobert1, Fréderic Dailler1

  • 1Neurological Intensive Care Unit, Civil Hospices of Lyon, Bron, Cedex, France.

World Neurosurgery
|January 27, 2019
PubMed
Summary

Delayed cerebral infarction (DCI) and seizures are difficult to diagnose after subarachnoid hemorrhage (SAH). Multimodal evaluation aids in detecting and treating these serious secondary brain complications.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Critical Care Medicine

Background:

  • Secondary brain injuries, including delayed cerebral infarction (DCI), are primary causes of disability following subarachnoid hemorrhage (SAH).
  • Diagnosing DCI presents challenges, particularly in patients with altered consciousness levels.
  • Subarachnoid hemorrhage (SAH) can lead to various secondary complications, such as DCI, seizures, and hydrocephalus, which are often clinically difficult to identify.

Purpose of the Study:

  • To highlight the diagnostic challenges of secondary brain injuries after SAH.
  • To present a case illustrating the multimodal diagnostic approach for DCI and nonconvulsive seizures post-SAH.
  • To emphasize the importance of a comprehensive evaluation for timely detection and management of SAH complications.

Main Methods:

Keywords:
Computed tomographyContinuous EEGDelayed cerebral ischemiaSubarachnoid hemorrhageTranscranial DopplerVasospasm

Related Experiment Videos

  • Case report of a patient experiencing acute hemiplegia four days after SAH.
  • Utilized transcranial Doppler (TCD) to assess blood flow velocities, indicating vasospasm.
  • Employed computed tomography (CT) perfusion and continuous electroencephalography (EEG) for a full diagnostic work-up.

Main Results:

  • The patient presented with acute hemiplegia and elevated blood flow velocities on TCD, suggestive of vasospasm.
  • Diagnostic work-up revealed nonconvulsive seizures as the cause of symptoms.
  • The case demonstrated the complexity of diagnosing secondary complications after SAH.

Conclusions:

  • Multimodal evaluation, integrating TCD, CT/MRI, and EEG, is crucial for diagnosing late complications after SAH.
  • Early detection and treatment of secondary complications like DCI, seizures, and hydrocephalus are vital for improving patient outcomes.
  • A systematic, multimodal approach ensures comprehensive assessment and management of patients with subarachnoid hemorrhage.