Subependymoma presenting as subarachnoid hemorrhage

1981 ◽  
Vol 55 (4) ◽  
pp. 643-645 ◽  
Author(s):  
David G. Changaris ◽  
James M. Powers ◽  
Phanor L. Perot ◽  
G. Douglas Hungerford ◽  
George B. Neal

✓ Symptomatic subarachnoid hemorrhage (SAH) in a young patient originated in a non-obstructive lateral ventricular subependymoma. A brief review of brain tumors known to cause SAH is discussed. The computerized tomography scans are presented.

2003 ◽  
Vol 98 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Cristina Mattioli ◽  
Luigi Beretta ◽  
Simonetta Gerevini ◽  
Fabrizio Veglia ◽  
Giuseppe Citerio ◽  
...  

Object. The goal of this study was fourfold: 1) to determine the incidence of traumatic subarachnoid hemorrhage (tSAH) in patients with traumatic brain injury (TBI); 2) to verify agreement in the diagnosis of tSAH in a multicenter study; 3) to assess the incidence of tSAH on the outcome of the patient; and 4) to establish whether tSAH itself leads to an unfavorable outcome or whether it is a sign of major brain trauma associated with severe posttraumatic lesions. Methods. Computerized tomography (CT) scans obtained in 169 head-injured patients on admission to 12 Italian intensive care units during a 3-month period were examined. The scans were collected for neuroradiological review and were used for the analysis together with data from a multicenter database (Neurolink). A review committee found a high incidence of tSAH (61%) in patients with TBI and a moderate agreement among centers (K = 0.57). Significant associations were observed between the presence and grading of tSAH and patient outcomes, and between the presence of tSAH and the severity of the CT findings. Logistic regression analysis showed that the presence of tSAH and its grading alone do not assume statistical significance in the prediction of unfavorable outcome. Conclusions. Traumatic SAH frequently occurs in patients with TBI, but it is difficult to detect and grade. Traumatic SAH is associated with more severe CT findings and a worse patient outcome.


1999 ◽  
Vol 90 (1) ◽  
pp. 153-155 ◽  
Author(s):  
Henry W. S. Schroeder ◽  
Rolf W. Warzok ◽  
Jamal A. Assaf ◽  
Michael R. Gaab

✓ In recent years, endoscopic third ventriculostomy has become a well-established procedure for the treatment of various forms of noncommunicating hydrocephalus. Endoscopic third ventriculostomy is considered to be an easy and safe procedure. Complications have rarely been reported in the literature. The authors present a case in which the patient suffered a fatal subarachnoid hemorrhage (SAH) after endoscopic third ventriculostomy.This 63-year-old man presented with confusion and drowsiness and was admitted in to the hospital in poor general condition. Computerized tomography scanning revealed an obstructive hydrocephalus caused by a tumor located in the cerebellopontine angle. An endoscopic third ventriculostomy was performed with the aid of a Fogarty balloon catheter. Some hours postoperatively, the patient became comatose. Computerized tomography scanning revealed a severe perimesencephalic—peripontine SAH and progressive hydrocephalus. Despite emergency external ventricular drainage, the patient died a few hours later.Although endoscopic third ventriculostomy is considered to be a simple and safe procedure, one should be aware that severe and sometimes fatal complications may occur. To avoid vascular injury, perforation of the floor of the third ventricle should be performed in the midline, halfway between the infundibular recess and the mammillary bodies, just behind the dorsum sellae.


1989 ◽  
Vol 70 (2) ◽  
pp. 280-281 ◽  
Author(s):  
Henry Hirschberg

✓ A method is described for marking the site of a tumor on the scalp based on information from computerized tomography (CT) scans. The technique employs a syrinx-shaped array of radiopaque catheters of varying length taped to the patient's scalp for visualization on the CT scan. Fiducial markings on the CT images allow the transfer of the tumor's location directly onto the scalp. The device can be placed anywhere on the scalp, including in a parasagittal position.


1993 ◽  
Vol 78 (3) ◽  
pp. 423-429 ◽  
Author(s):  
Masami Shimoda ◽  
Shinri Oda ◽  
Ryuichi Tsugane ◽  
Osamu Sato

✓ This investigation has revealed the frequency of various intracranial complications that may result from hypervolemic therapy for a delayed ischemic deficit following subarachnoid hemorrhage (SAH). Among 323 patients with SAH, 112 patients developed a delayed ischemic deficit, 94 of whom underwent hypervolemic therapy. Infarction due to vasospasm was found ultimately in 43 of these 94 patients. Twenty-six patients (28%) developed an intracranial complication during hypervolemic therapy: cerebral edema was aggravated in 18, and a hemorrhagic infarction developed in eight. In 13 of 18 patients with aggravation of edema, delayed ischemic deficit developed within 6 days after the SAH; at that time, a massive new infarction was found in four and edema in 10 patients. After hypervolemic therapy, the 18 patients with aggravation of edema deteriorated rapidly, and 14 of them died. In every case in which hemorrhagic infarction followed hypervolemic therapy, a new infarct was found on computerized tomography (CT) when the delayed ischemic deficit became apparent. Hemorrhagic infarction developed as the delayed ischemic deficit resolved, with one exception. In patients who sustained no complication from hypervolemia, the incidence of both massive new infarction and edema at the time when the delayed ischemic deficit was manifested was only 1%. In 44 of 68 patients who sustained no complication from hypervolemia, the delayed ischemic deficit was manifested on or after the 7th day following the SAH. This study suggests that hypervolemic therapy is contraindicated in a patient who is found to have a massive abnormality on CT at the time when a delayed ischemic deficit is manifested, especially when it occurs within 6 days after the SAH. To avoid hemorrhagic infarction, it is important to discontinue hypervolemic therapy as soon as the delayed ischemic deficit resolves.


1984 ◽  
Vol 60 (2) ◽  
pp. 348-353 ◽  
Author(s):  
Nobuhiko Aoki ◽  
Hiroshi Mizutani

✓ The majority of patients with intracranial hemorrhage associated with moyamoya disease have been described as having subarachnoid hemorrhage (SAH), but it seems doubtful that moyamoya disease causes primary SAH. Computerized tomography (CT) has revealed that most of the hemorrhage found in cases of moyamoya disease is intracerebral or intraventricular. The authors have reviewed 54 cases of intracranial hemorrhage confirmed by CT, including nine of their own, and found that in all but one the bleeding was intracerebral or intraventricular. The single case of SAH was due to rupture of a saccular aneurysm associated with moyamoya disease. It may be concluded from these results that moyamoya disease does not cause primary SAH per se.


2001 ◽  
Vol 95 (2) ◽  
pp. 206-212 ◽  
Author(s):  
Birgitta K. Velthuis ◽  
Maarten S. van Leeuwen ◽  
Theodoor D. Witkamp ◽  
Lino M. P. Ramos ◽  
Jan Willem Berkelbach van der Sprenkel ◽  
...  

Object. The purpose of this study was to compare computerized tomography (CT) angiography and digital subtraction (DS) angiography studies in patients with subarachnoid hemorrhage (SAH) to assess their vascular anatomy relevant to cerebral aneurysm surgery. Methods. From a prospective series of 100 patients with SAH, the authors selected 73 patients whose CT angiography studies were of adequate quality and in whom DS angiography of both carotid arteries had been performed. Eleven patients with no DS angiographic studies of the vertebrobasilar artery were only evaluated for the anterior half of the circle of Willis. Anterior communicating arteries (ACoAs), both precommunicating anterior cerebral arteries (A1 segments), both posterior communicating arteries (PCoAs), and both precommunicating posterior cerebral arteries (P1 segments) were assessed on CT angiography and DS angiography by two independent observers. Conclusions. Computerized tomography angiography compares well with DS angiography for visualizing normal-sized arteries, and is superior for visualizing ACoAs and hypoplastic A1 and P1 segments. Important preoperative aspects such as dominant A1 segments and PCoAs are equally well seen using either modality. Neither method enabled the authors to visualize more than 50% of PCoAs. Use of CT angiography can provide the required preoperative anatomical information for aneurysm surgery in most patients with SAH.


1983 ◽  
Vol 58 (5) ◽  
pp. 650-653 ◽  
Author(s):  
Nicholas J. Patronas ◽  
Javad Hekmatpanah ◽  
Kunio Doi

✓ Perfluorocarbon, a new tumor-seeking x-ray contrast agent, was injected into three rats with experimental brain tumors. After 1 to 3 days the rats were sacrificed, and the brains were removed and subjected to x-ray study. All showed dense radiopaque areas which correlated with the size and shape of the corresponding brain tumors. Conversely, none of the radiograms taken of the brain tumor in five rats receiving no perfluorocarbon (control animals) showed similar increased density. These findings suggest that perfluorocarbon may serve a useful role as a contrast medium for computerized tomography studies of brain tumors in man.


1987 ◽  
Vol 66 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Richard Leblanc

✓ Thirty-four of 87 consecutive patients with subarachnoid hemorrhage from a cerebral aneurysm had a premonitory minor leak. There were 12 men and 22 women, aged 25 to 73 years (mean 44.4 years). Twenty-two had a small and 12 had a large aneurysm located on the internal carotid artery (17 cases), anterior communicating artery (10 cases), middle cerebral artery (five cases), and pericallosal artery (two cases). Fifty-two percent of patients with a minor leak from an internal carotid artery aneurysm had ipsilateral, hemicranial, hemifacial, or periorbital pain. Half of the patients initially saw a physician, but in no case was the correct diagnosis made. Twenty-five patients had a major rupture within 24 hours to 4 weeks after findings suggesting a minor leak, with a mortality rate of 53%. Nine other patients were diagnosed by lumbar puncture or computerized tomography (CT) scanning after initial misdiagnosis and were operated on, without mortality, before a major rupture could occur. The CT scans were negative in 55% of patients with a minor leak, but lumbar puncture, when performed, was always positive. A minor leak prior to major aneurysmal rupture is a common occurrence and, if unrecognized, is associated with a high mortality. Computerized tomography scanning is unreliable in diagnosing this event, and lumbar puncture is the examination of choice once intracranial hypertension has been ruled out.


1996 ◽  
Vol 85 (1) ◽  
pp. 82-89 ◽  
Author(s):  
Albrecht Harders ◽  
Algirdas Kakarieka ◽  
Reinder Braakman ◽  
_ _

✓ A prospective, randomized, double-blind, placebo-controlled study of nimodipine used to treat traumatic subarachnoid hemorrhage (tSAH) was conducted in 21 German neurosurgical centers between January 1994 and April 1995. One hundred twenty-three patients with tSAH appearing on initial computerized tomography (CT) scanning were entered into the study. Requirements for inclusion included age between 16 and 70 and admission into the study within 12 hours after head injury, regardless of the patient's level of consciousness. Eligible patients received either a sequential course of intravenous and oral nimodipine or placebo treatment for 3 weeks. Patients were closely monitored using clinical neurology, computerized tomography, laboratory, and transcranial Doppler ultrasound parameters. Patients treated with nimodipine had a significantly less unfavorable outcome (death, vegetative survival, or severe disability) at 6 months than placebo-treated patients (25% vs. 46%, p = 0.02). The relative reduction in unfavorable outcome in the nimodipine-treated group was even higher (55%, p = 0.002) when only patients who complied with the protocol were considered.


1982 ◽  
Vol 56 (1) ◽  
pp. 154-157 ◽  
Author(s):  
Roland N. Auer ◽  
James Budny ◽  
Charles G. Drake ◽  
Melvyn J. Ball

✓ A 15-year-old youth presented with a history and computerized tomography picture of subarachnoid hemorrhage. Conservative management was undertaken after failure to demonstrate an aneurysm. Reevaluation and operation 15 months later disclosed a firm leathery schwannoma intimately related to the frontal lobe and extending into the cortex in the Virchow-Robin spaces.


Sign in / Sign up

Export Citation Format

Share Document