Subarachnoid hemorrhage in pregnancy

1972 ◽  
Vol 36 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Julian L. Robinson ◽  
Charles J. Hall ◽  
Carol B. Sedzimir
Keyword(s):  
Cardiac Output ◽  
Subarachnoid Hemorrhage ◽  
Clinical Features ◽  
Content Type ◽  
Cardiovascular Changes ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Obstetrical Management ◽  
Fine Print ◽  
In Pregnancy

✓ A series of women who had spontaneous subarachnoid hemorrhage during pregnancy is reviewed. These patients are more likely than the average to have an angiographically demonstrable lesion, with arteriovenous anomalies and aneurysms occurring equally. The clinical features are evaluated so that an idea of the causative lesion can be gained at the bedside in the absence of specific neurological tests. When the known cardiovascular changes of pregnancy are correlated with the clinical features in these patients, it is found that subarachnoid hemorrhage from an arteriovenous anomaly or aneurysm in pregnancy is not related to the increased cardiac output. From these data, the preferred neurosurgical and obstetrical management is defined.

Hydrocephalus following spontaneous subarachnoid hemorrhage

1973 ◽  
Vol 39 (4) ◽  
pp. 474-479 ◽  
Author(s):  
M. Gazi Yasargil ◽  
Yasuhiro Yonekawa ◽  
Bruno Zumstein ◽  
Hans-Jürgen Stahl
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Features ◽  
Intracranial Aneurysms ◽  
Communicating Hydrocephalus ◽  
Content Type ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
The Relationship ◽  
Ruptured Intracranial Aneurysms ◽  
Fine Print

✓ Twenty-eight cases of communicating hydrocephalus after subarachnoid hemorrhage (SAH) due to ruptured intracranial aneurysms are reported. The relationship between the incidence of this complication and the various clinical features of SAH is discussed. The findings of RISA cisternography have little relationship to the findings of pneumoencephalography or the results of shunting procedures. The availability and value of echoencephalography in treating such patients is emphasized.

Chronic subdural hematoma presenting as spontaneous subarachnoid hemorrhage

1985 ◽  
Vol 63 (5) ◽  
pp. 691-692 ◽  
Author(s):  
Zbigniew Kotwica ◽  
Jerzy Brzeziński
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Clinical Findings ◽  
Content Type ◽  
Acute Subarachnoid Hemorrhage ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Fine Print

✓ Six cases of chronic subdural hematoma presenting with the clinical findings of acute subarachnoid hemorrhage are reported. No systemic or focal cause for the bleeding was found, and possible mechanisms are discussed.

Ultra-early rebleeding in spontaneous subarachnoid hemorrhage

1996 ◽  
Vol 84 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Yukihiko Fujii ◽  
Shigekazu Takeuchi ◽  
Osamu Sasaki ◽  
Takashi Minakawa ◽  
Tetsuo Koike ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Multivariate Analysis ◽  
Subarachnoid Hemorrhage ◽  
Early Operation ◽  
Time Interval ◽  
High Systolic Blood Pressure ◽  
Content Type ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Fine Print

✓ To determine the incidence of, and risk factors for, the occurrence of rebleeding between admission and early operation (ultra-early rebleeding) in patients with spontaneous subarachnoid hemorrhage (SAH), the authors reviewed the cases of 179 patients admitted within 24 hours after their last attack of SAH. Thirty-one (17.3%) of these patients had ultra-early rebleeding despite scheduling of early operation (within 24 hours after admission). The incidence of rebleeding significantly decreased as the time interval between the last attack and admission increased. Patients with rebleeding before admission, high systolic blood pressure, intracerebral or intraventricular hematoma, those in poor neurological condition on admission, and those who underwent angiography within 6 hours of the last SAH were significantly more likely to have ultra-early rebleeding than those without these factors. The incidence of rebleeding also significantly increased as levels of enhancement of platelet sensitivity and thrombin—antithrombin complex increased. Multivariate analysis revealed that the following three factors were independently associated with ultra-early rebleeding: the level of enhancement of platelet sensitivity; the time interval between the last attack and admission; and the level of thrombin—antithrombin complex. On the basis of these findings, the authors suggest that many of the risk factors for ultra-early rebleeding are interrelated. A particularly high risk of ultra-early rebleeding was observed in those patients 1) who had platelet hypoaggregability; 2) who were admitted shortly after their last SAH; and 3) whose thrombin—antithrombin complex levels were extremely high and were thus in severe clinical condition.

Spontaneous subarachnoid hemorrhage associated with spinal cord tumor

1974 ◽  
Vol 40 (2) ◽  
pp. 252-254 ◽  
Author(s):  
John B. Runnels ◽  
John W. Hanbery
Keyword(s):  
Spinal Cord ◽  
Differential Diagnosis ◽  
Subarachnoid Hemorrhage ◽  
Rare Case ◽  
Spinal Cord Tumor ◽  
Content Type ◽  
Upper Thoracic ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Fine Print

✓ A rare case of spontaneous subarachnoid hemorrhage from an extramedullary upper thoracic astrocytoma is described. The differential diagnosis between cranial and spinal spontaneous subarachnoid hemorrhage is discussed.

Spontaneous subarachnoid hemorrhage and negative cerebral panangiography

1986 ◽  
Vol 64 (4) ◽  
pp. 537-542 ◽  
Author(s):  
Mark S. M. Alexander ◽  
P. S. Dias ◽  
David Uttley
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Loss Of Consciousness ◽  
Clinical Grade ◽  
Content Type ◽  
Subarachnoid Blood ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Eventual Outcome ◽  
Basal Cisterns ◽  
Fine Print

✓ One hundred and forty consecutive patients who sustained proven spontaneous subarachnoid hemorrhage (SAH) with negative cerebral panangiography were studied retrospectively. Attention was directed to the presence, amount, and distribution of subarachnoid blood on computerized tomography (CT) scans. It was determined that the finding of blood on CT had a significant association with clinical grade, loss of consciousness, ventricular ratio, fixed ischemic deficit, and total of all complications, but not with epilepsy, hypertension (previously known or detected on admission), treated hydrocephalus, rebleeding, angiographic spasm, and eventual outcome (which was generally excellent on follow-up examination). The distribution of blood, predominantly around the basal cisterns, suggests leakage from ventriculostriate and thalamoperforating vessels as the cause of SAH, and closer study of these vessels is suggested.

Spontaneous subarachnoid hemorrhage first from an intracranial and then from a spinal arteriovenous malformation

1977 ◽  
Vol 47 (6) ◽  
pp. 965-968 ◽  
Author(s):  
Dwight Parkinson ◽  
Michael West
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Cerebral Arteriovenous Malformation ◽  
Cerebral Arteriovenous Malformations ◽  
Content Type ◽  
Spinal Arteriovenous Malformation ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Spinal Avm ◽  
Fine Print

✓ A patient presented with spontaneous subarachnoid hemorrhage (SAH) from a cerebral arteriovenous malformation (AVM) which was later totally removed at surgery. The patient presented again with a new SAH from a spinal AVM that was also totally removed at surgery. Coexistence of spinal and cerebral arteriovenous malformations are exceedingly rare and hemorrhage from each is not previously reported. This case emphasizes the importance of investigating the spinal canal in otherwise unexplained spontaneous SAH.

Causes of spontaneous subarachnoid hemorrhage in Thai infants and children

1980 ◽  
Vol 53 (2) ◽  
pp. 185-187 ◽  
Author(s):  
Pongsakdi Visudhiphan ◽  
Surang Chiemchanya ◽  
Racha Somburanasin ◽  
Dhanit Dheandhanoo
Keyword(s):  
Cerebrospinal Fluid ◽  
Subarachnoid Hemorrhage ◽  
Arteriovenous Malformations ◽  
Infants And Children ◽  
Content Type ◽  
Cerebrospinal Fluid Examination ◽  
Hemorrhagic Disorders ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Fine Print

✓ The authors report 56 cases of spontaneous subarachnoid hemorrhage in Thai infants and children. The causes were: hemorrhagic disorders in 22 cases, arteriovenous malformations and aneurysms in 18, gnathostomiasis in nine, bleeding tumors in four, hypernatremia in one, and undetermined causes in two cases. Coagulation studies and cerebrospinal fluid examination for eosinophils are recommended before further invasive studies in such cases.

Use of the peak troponin value to differentiate myocardial infarction from reversible neurogenic left ventricular dysfunction associated with aneurysmal subarachnoid hemorrhage

2003 ◽  
Vol 98 (3) ◽  
pp. 524-528 ◽  
Author(s):  
Ketan R. Bulsara ◽  
Matthew J. McGirt ◽  
Lawrence Liao ◽  
Alan T. Villavicencio ◽  
Cecil Borel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Output ◽  
Subarachnoid Hemorrhage ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Surgical Intervention ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Left Ventricular ◽  
Content Type ◽  
Fine Print

Object. Differentiating myocardial infarction (MI) from reversible neurogenic left ventricular dysfunction (stunned myocardium [SM]) associated with aneurysmal subarachnoid hemorrhage (SAH) is critical for early surgical intervention. The authors hypothesized that the cardiac troponin (cTn) trend and/or echocardiogram could be used to differentiate between the two entities. Methods. A retrospective study was conducted for the period between 1995 and 2000. All patients included in the study met the following criteria: 1) no history of cardiac problems; 2) new onset of abnormal cardiac function (ejection fraction [EF] < 40% on echocardiograms); 3) serial cardiac markers (cTn and creatine kinase MB isoform [CK-MB]); 4) surgical intervention for their aneurysm; and 5) cardiac output monitoring either by repeated echocardiograms or invasive hemodynamic monitoring during the first 4 days post-SAH when the patients were euvolemic. Of the 350 patients with SAH, 10 (2.9%) had severe cardiac dysfunction. Of those 10, six were women and four were men. The patients' mean age was 53.5 years (range 29–75 years) and their SAH was classified as Hunt and Hess Grade III or IV. Aneurysm distribution was as follows: basilar artery tip (four); anterior communicating artery (two); middle cerebral artery (one); posterior communicating artery (two); and posterior inferior cerebellar artery (one). The mean EF at onset was 33%. The changes on echocardiograms in these patients did not match the findings on electrocardiograms (EKGs). Within 4.5 days, dramatic improvement was seen in cardiac output (from 4.93 ± 1.16 L/minute to 7.74 ± 0.88 L/minute). Compared with historical controls in whom there were similar levels of left ventricular dysfunction after MI, there was no difference in peak CK-MB. A 10-fold difference, however, was noted in cTn values (0.22 ± 0.25 ng/ml; control 2.8 ng/ml; p < 0.001). Conclusions. The authors determined the following: 1) that the CK-MB trend does not allow differentiation between SM and MI; 2) that echocardiograms revealing significant inconsistencies with EKGs are indicative of SM; and 3) that cTn values less than 2.8 ng/ml in patients with EFs less than 40% are consistent with SM.

Structural changes of the intradural arteries following subarachnoid hemorrhage

1972 ◽  
Vol 37 (6) ◽  
pp. 715-723 ◽  
Author(s):  
Louis W. Conway ◽  
Larry W. McDonald
Keyword(s):  
Structural Change ◽  
Subarachnoid Hemorrhage ◽  
Structural Changes ◽  
Intimal Thickening ◽  
Muscular Layer ◽  
Content Type ◽  
Intracranial Arteries ◽  
Subarachnoid Blood ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Fine Print

✓ The histology of the intradural arteries was studied in 12 consecutive autopsy cases of patients dying 1 day to 15 months after their initial spontaneous subarachnoid hemorrhage. In all patients surviving 4 weeks or more and in one surviving 4 days, the lumina of the intracranial arteries were narrowed by subendothelial granulation tissue which thickened the intima. In all seven cases with structural changes in the intracranial arteries, vessels near the site of hemorrhage were involved; in four cases vessels remote from the site of hemorrhage were also involved. Changes were usually restricted to large arteries with a prominent muscular layer and confined to the subarachnoid space. The presence and degree of intimal thickening correlated with the distribution and amount of subarachnoid blood or its breakdown products. This process apparently does not represent an obliterative endarteritis involving vessels exclusively supplying infarcted brain, but is probably a reaction to mechanical or anoxic damage to the intima following vasoconstriction. It is suggested that this arterial structural change might be confused with delayed or prolonged “vasopasm.”

Documented enlargement and rupture of a small arterial sacculation

1971 ◽  
Vol 34 (6) ◽  
pp. 814-817 ◽  
Author(s):  
Byron Young ◽  
William F. Meacham ◽  
Joseph H. Allen
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Content Type ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Small Aneurysms ◽  
Fine Print

✓ Small aneurysms may sometimes be considered junctional dilatations but may also progressively enlarge and cause spontaneous subarachnoid hemorrhage, as in the case reported. These small aneurysms should be treated precisely as an aneurysm directly responsible for bleeding. When found in conjunction with other aneurysms, they should either be treated simultaneously or followed until clinical developments indicate the need for such surgery.

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