Diagnostic value of non-enhanced computed tomography in identifying location of ruptured cerebral aneurysm in patients with aneurysmal subarachnoid haemorrhage.

Diagnostic value of non-enhanced computed tomography in identifying location of ruptured cerebral aneurysm in patients with aneurysmal subarachnoid haemorrhage. Neurol Neurochir Pol. 2020 Jan 22;: Authors: Sawicki M, Kościukiewicz K, Jeżewski D, Chełstowski K, Gołofit P, Skoczylas MM, Gębka M, Grabizna K, Kołaczyk K, Zwarzany Ł, Sagan L, Poncyljusz W Abstract BACKGROUND: In patients with SAH and multiple aneurysms, the ruptured lesion must be identified to prevent recurrent bleeding. AIM OF THE STUDY: To assess the diagnostic value of non-enhanced computed tomography (NECT) in identifying the rupture site in patients with subarachnoid haemorrhage (SAH) and multiple aneurysms. MATERIAL AND METHODS: We included patients with SAH revealed by NECT and multiple aneurysms detected on computed tomography angiography (CTA) in whom a ruptured aneurysm was identified during neurosurgery. Two radiologists predicted the location of the ruptured aneurysm based on the distribution of the SAH and location of intracerebral haematoma (ICH) by NECT. RESULTS: Eighty-three patients with a mean age of 55.7 ± 14.4 years were included. Ruptured aneurysms were significantly larger (mean size 7.7 ± 4.7 mm) than unruptured aneurysms (mean size 5.9 ± 4.5 mm; p = 0.014). Interobserver agreement was 0.86 (p
Source: Neurologia i Neurochirurgia Polska - Category: Neurology Authors: Tags: Neurol Neurochir Pol Source Type: research

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ConclusionTraumatic dACA aneurysm is a rare complication of brain trauma. Delayed intracranial haemorrhage and the sudden deterioration of neurologic function were the typical characteristics in patients with traumatic dACA aneurysm. CTA is the first-line screening modality for patients who present with intracerebral haemorrhage in the corpus callosum after trauma, particularly for patients who are older, in a poorer or critical condition. When the aneurysm is located in the A4 segment or involves a small branch, surgical trapping is the preferred definitive therapy to prevent further growth and disastrous bleeding. Early ...
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research
Conclusion: Neuro-endoscopic hematoma removal may be the optimal management method for hemorrhagic MMD in the acute stage in terms of the maximum preservation of pre-existing collateral anastomosis without affecting the potential donor vessels used for future revascularization surgery. Abbreviations: MMD: Moyamoya disease; STA: Superficial temporal artery; MCA: Middle cerebral artery; JAM: Japan Adult Moyamoya; ICH: Intracerebral hemorrhage; IVH: Intraventricular hemorrhage; SAH: Subarachnoid hemorrhage; CT: Computed tomography; TE: Total evacuation; PE: Partial evacuation; SMR: Light mass reduction; MR: Magnetic resonance...
Source: Neurological Research - Category: Neurology Tags: Neurol Res Source Type: research
CONCLUSION: Despite the high risk of aneurysmal rebleeding within a few hours after SAH, emergency cerebral angiography after SAH can be acceptable without increasing the risk of intra-angiographic rebleeding when using current angiographic techniques and equipment. PMID: 31484228 [PubMed]
Source: Journal of Korean Neurosurgical Society - Category: Neurosurgery Tags: J Korean Neurosurg Soc Source Type: research
ConclusionPediatric aneurysms are rare, and often present as dissecting thrombosed aneurysms or giant aneurysms. ACA dissecting aneurysms are rare but often occur at a young age, and they easily cause thrombosis, which may occlude the aneurysm and the parent artery, resulting in unknown bleeding sources.It is necessary to suspect rupture of an ACA dissecting aneurysm if there is an ICH and SAH of an unknown source of bleeding where the hematoma is localized near the ACA. Craniotomy can effectively remove the hematoma and identify the bleeding source, and it is more desirable to secure the parent artery to prevent re-rupture.
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research
Background: To determine the clinical outcomes of perimesencephalic subarachnoid hemorrhages based on the computed tomography (CT) bleeding patterns. Methods: This retrospective cohort study included: (1) patients ( ≥18 years) admitted to a comprehensive stroke center (January 2015-May 2018), (2) with angiography-negative, nontraumatic subarachnoid hemorrhage in a perimesencephalic or diffuse bleeding pattern, and (3) had CT imaging performed in less than rqual to 72 hours of symptom onset. Patients were stra tified by location of bleeding on CT: Peri-1: focal prepontine hemorrhage; Peri-2: prepontine with suprasellar c...
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
Conclusion: The authors experienced a notably rare image of the extravasation from middle cerebral artery and middle meningeal artery in the cerebral angiography. When an obscure arterial abnormality is suspected on CTA for the unknown origin SAH with ASDH, the authors may have an affirmative attitude toward performing conventional cerebral angiography, which is most promising modality to detect the source of bleeding including CEV.
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Clinical Studies Source Type: research
DISCUSSION: To the best of our knowledge, this study is the first to correlate the levels of endogenous NPY in supratentorial CSF with cognitive outcome in good-grade sSAH patients. Excessive NPY release into CSF may have a short-term influence on the pathogenesis of neuropsychological deficits. The impact of cerebrovascular manipulation on NPY release has to be further elucidated. ABBREVIATIONS: ANOVA: analysis of variance; aSAH: aneurysmal subarachnoid haemorrhage; AUC: area under the curve; CBF: cerebral blood flow; CSF: cerebrospinal fluid; CT (scan): computed tomography (scan); CV: cerebral vasospasm; DIND: delaye...
Source: Neurological Research - Category: Neurology Tags: Neurol Res Source Type: research
Publication date: June 2018 Source:Journal of Clinical Neuroscience, Volume 52 Author(s): Elias Atallah, Sophia Dang, Sage Rahm, James Feghali, Chalouhi Nohra, Stavropoula Tjoumakaris, Robert H. Rosenwasser, Hekmat Zarzour, Nabeel Herial, Michael Reid Gooch, Pascal Jabbour Spinal arachnoiditis (SA) is an extremely rare and delayed complication of subarachnoid hemorrhage (SAH). Little is known about its underlying pathogenesis and subsequent clinical course. A middle-aged patient presented with the worst headache of her life and a grade 3 SAH of the basal-cisterns and posterior fossa was identified on Computed Tomography s...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
​BY TRAVIS SMITH, MD, &MATTHEW ZUCKERMAN, MDParamedics were called for a 42-year-old woman found at a motel by her significant other. The patient was alone at the time of EMS arrival. She was pulseless and apneic, so chest compressions were started, and the cardiac monitor showed pulseless electrical activity.Initial ECG showing STE in the anterior leads with ST depression in the inferior leads.The paramedics gave her 1 mg of epinephrine IV and 1 mg of naloxone IV without obvious response. A laryngeal mask airway was placed, and oxygen was delivered by bag valve mask. She received eight rounds of chest compressi...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Conclusion: Defining the vascular pathology by CTA directly at the emergency site may be beneficial in triaging patients with various cerebrovascular diseases to the most appropriate target hospital and specialized treatment.Cerebrovasc Dis 2017;44:338 –343
Source: Cerebrovascular Diseases - Category: Neurology Source Type: research
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