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[Perimesencephalic subarachnoid hemorrhage]

I A Hynås1, E Kerty, R Nyberg-Hansen

  • 1Nevrologisk avdeling, Rikshospitalet, Oslo.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|May 20, 1997
PubMed
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Acute subarachnoid haemorrhage, often fatal, can stem from ruptured aneurysms. Perimesencephalic haemorrhage, a specific type, shows a distinct pattern on CT scans and is linked to a better prognosis.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Acute, non-traumatic subarachnoid haemorrhage (SAH) is a critical neurological condition with high mortality, typically caused by ruptured cerebral aneurysms.
  • Perimesencephalic haemorrhage (PPH) has emerged as a distinct clinical subset of SAH.

Observation:

  • Computed tomography (CT) imaging reveals a characteristic pattern of haemorrhage predominantly confined to the perimesencephalic cisterns in PPH.
  • This specific CT pattern is strongly associated with negative findings on subsequent cerebral angiography.

Findings:

  • Patients with perimesencephalic haemorrhage exhibit an excellent clinical prognosis compared to other forms of SAH.
  • The study presents two cases illustrating the clinical presentation and diagnostic features of perimesencephalic haemorrhage.

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Implications:

  • Identifying PPH through characteristic CT findings allows for early prediction of a favorable outcome.
  • This subset recognition aids in avoiding unnecessary invasive diagnostic procedures like angiography in select SAH cases.
  • Understanding PPH contributes to refining diagnostic and management strategies for non-traumatic subarachnoid haemorrhage.