Subarachnoid hemorrhage, aneurysms, and vascular malformations

✓Subarachnoid hemorrhage (SAH) of spinal origin is a rare entity accounting for approximately 1% of all cases of SAH. Its most frequent causes are trauma and vascular malformations. Although primary spinal tumors, especially ependymomas, are also relatively common causes, SAH secondary to a metastatic spinal tumor arising from outside the central nervous system is an extremely rare condition; only one case has been reported in the literature. The authors present a case of spinal meningeal carcinomatosis secondary to cutaneous malignant melanoma in which the patient presented with only symptoms of SAH. Although very rare, this case underscores several factors. 1) Spinal SAH due to spinal metastases should be considered in the differential diagnosis of patients with previously known malignancy. 2) Spinal SAH may manifest without paraparesis or sensory deficit. 3) Magnetic resonance imaging of the spinal cord may be important to determine the source of SAH in patients in whom four-vessel cerebral angiography demonstrates no abnormal findings.

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Intracranial hemorrhage, vascular malformations, cerebral aneurysms, and subarachnoid hemorrhage

Textbook of Clinical Neuropsychology ◽

10.4324/9781315537511-34 ◽

2016 ◽

pp. 412-430

Keyword(s):

Subarachnoid Hemorrhage ◽

Intracranial Hemorrhage ◽

Vascular Malformations ◽

Cerebral Aneurysms

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Spinal vascular malformations in non-perimesencephalic subarachnoid hemorrhage

Journal of Neurology ◽

10.1007/s00415-009-0021-4 ◽

2008 ◽

Vol 255 (12) ◽

pp. 1910-1915 ◽

Cited By ~ 11

Author(s):

M. R. Germans ◽

F. A. Pennings ◽

M. E. S. Sprengers ◽

W. P. Vandertop

Keyword(s):

Subarachnoid Hemorrhage ◽

Vascular Malformations ◽

Perimesencephalic Subarachnoid Hemorrhage ◽

Spinal Vascular Malformations

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Subarachnoid hemorrhage from sudden gravitational changes

The Neuroradiology Journal ◽

10.1177/19714009211030540 ◽

2021 ◽

pp. 197140092110305

Author(s):

Alejandro A Rabinstein ◽

Sherri A Braksick ◽

Eelco FM Wijdicks

Keyword(s):

Subarachnoid Hemorrhage ◽

Cerebral Vasospasm ◽

Intracranial Aneurysms ◽

Clinical Course ◽

Vascular Malformations ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Characteristic Pattern ◽

Rare Phenomenon ◽

The Future

Diffuse subarachnoid hemorrhage is commonly attributed to the rupture of intracranial aneurysms or other vascular malformations. Non-aneurysmal hemorrhages often have a characteristic pattern or clear mechanism (e.g. trauma) with an often more benign clinical course. We report the case of a diffuse non-aneurysmal subarachnoid hemorrhage due to sudden gravitational changes encountered during complex airflight maneuvers, complicated by hydrocephalus and cerebral vasospasm. This case illustrates a rare phenomenon that may again be encountered in the future with the advent and advancement of civilian spaceflight.

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Transvenous embolization for craniocervical junction epidural arteriovenous fistula with a pial feeder aneurysm

Interventional Neuroradiology ◽

10.1177/1591019919874571 ◽

2019 ◽

Vol 26 (2) ◽

pp. 170-177

Author(s):

Keisuke Yoshida ◽

Shinsuke Sato ◽

Tatsuya Inoue ◽

Bikei Ryu ◽

Shogo Shima ◽

...

Keyword(s):

Subarachnoid Hemorrhage ◽

Arteriovenous Fistula ◽

Vascular Malformations ◽

Transarterial Embolization ◽

Venous Drainage ◽

Craniocervical Junction ◽

Transvenous Embolization ◽

Arteriovenous Fistulas ◽

Complete Obliteration ◽

Transvenous Approach

Arteriovenous fistulas at the craniocervical junction are rare vascular malformations with frequent hemorrhagic presentations, which may have a concurrent pial feeder aneurysm. A 65-year-old man presented with subarachnoid hemorrhage and angiography showed an epidural arteriovenous fistula at the C-2 level with an anterior spinal feeder aneurysm without perimedullary venous drainage. Transarterial coil embolization of the ruptured aneurysm and partial Onyx embolization of the shunt led to thrombosis of the aneurysm. However, three years later angiography showed an increased shunt flow and recurrence of the aneurysm. Transvenous embolization of the shunt using coils and Onyx yielded complete obliteration of the shunt, thus leading to occlusion of the aneurysm. This case demonstrates that partial transarterial embolization of arteriovenous fistula leaves a risk of rebleeding, whereas complete obliteration of the shunt with a transvenous approach can lead to disappearance of the flow-related aneurysm without embolization of the aneurysm itself.

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Cerebrospinal fluid creatine phosphokinase in acute subarachnoid hemorrhage

Journal of Neurosurgery ◽

10.3171/jns.1976.44.1.0050 ◽

1976 ◽

Vol 44 (1) ◽

pp. 50-54 ◽

Cited By ~ 7

Author(s):

Samuel H. Greenblatt

Keyword(s):

Cerebrospinal Fluid ◽

Subarachnoid Hemorrhage ◽

Creatine Phosphokinase ◽

Vascular Malformations ◽

Preoperative Management ◽

Diagnostic Specificity ◽

Cerebral Tissue ◽

Content Type ◽

Acute Subarachnoid Hemorrhage ◽

Destructive Processes

✓ The author measured the level of creatine phosphokinase (CPK) in 35 cerebrospinal fluid (CSF) specimens from 30 patients with acute subarachnoid hemorrhage, and correlations were sought with 17 other clinical and laboratory parameters. Elevations of CSF CPK have no diagnostic specificity. However, they do show a statistically significant correlation with the existence of any destructive process in cerebral tissue (hydrocephalus, infarction, intraparenchymal hemorrhage, or intraventricular clot). Yet arterial spasm without infarction does not raise the CSF CPK level. During the preoperative management of ruptured aneurysms and vascular malformations, a significant elevation of the CSF CPK level can thus provide a clue to the presence or significance of one or more of these destructive processes.

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