Superficial temporal artery-superior cerebellar artery bypass and proximal occlusion through anterior petrosal approach for subarachnoid hemorrhage due to basilar artery dissection.
Conclusion: Proximal occlusion of the basilar artery combined with STA-SCA bypass was successful in preventing rerupture of BAD and ensuring blood flow in the upper basilar region. Although there is controversy regarding acute treatment for ruptured BAD, direct proximal occlusion with sufficient revascularization using bypass skull base technique may be one of the optimal treatments even in this era of endovascular treatment. PMID: 33024594 [PubMed]
The broader differential diagnosis of postpartum headache, to which the authors of the case report have alluded, includes, not only the disorders cited by the authors as being the ones enumerated in Classical teaching in Emergency Medicine , but also the post partum headache of aortic dissection(AD) , reversible cerebral vasoconstrictor syndrome [3,4] non-aneurysmal subarachnoid hemorrhage  postpartum vertebral artery dissection , and internal carotid artery dissection . Awareness of the full spectrum of that differential diagnosis will optimise the management of postpartum patients who present to the emerge...
In this issue of the Journal of Stroke and Cerebrovascular Diseases, Chakraborty and colleagues describe the cautionary tale of a patient who presented with a thunderclap headache concerning for a subarachnoid hemorrhage (SAH). A head computed tomographic scan (CT) done 4 h after the onset of the headache was interpreted as negative but the patient was ultimately found to have an aneurysmal SAH.1
CONCLUSIONS: This study confirms that CV always follows aSAH. Future research into pathophysiology of CV is needed in order to determine exact treatment strategies and targets so treatment towards zero mortality can be achieved. PMID: 32893749 [PubMed - as supplied by publisher]
CONCLUSIONS: In conclusion, spinal HBL is an extremely rare cause of SAH. The systematic review found putative risk factors: female gender, age 40-50 years, cervical location, and median size 2 cm. Diagnosis can be difficult when presentation mimics intracerebral SAH. We advocate early surgical removal. The risk of rapidly fatal course in case of major hemorrhage needs to be borne in mind. PMID: 32866499 [PubMed - as supplied by publisher]
Publication date: September 2020Source: Journal of Clinical Neuroscience, Volume 79Author(s): Layton Lamsam, Hriday P. Bhambhvani, Ajith Thomas, John K Ratliff, Justin M. Moore
Publication date: December 2020Source: Interdisciplinary Neurosurgery, Volume 22Author(s): Garrett B. Hile, Aaron M. Cook
Rationale: Intracranial aneurysm with the first manifestation of acute subdural hematoma (aSDH) is rare in the field of neurosurgery. Usually subarachnoid hemorrhage or intracranial hematoma happens after the rupture of an intracranial aneurysm, whereas trauma is the primary cause of aSDH. Patient concerns: Here, we present the case of a 71-year-old woman who presented with spontaneous aSDH with progressive headache and vomiting. Diagnosis: Urgent head computed tomography (CT) identified an aSHD, but the patient had no history of trauma. CT angiography (CTA) identified the cause of the aSDH as rupture of an intracr...
Conclusions: While there was a trend toward lower pain scores and opioid requirement in the gabapentin group, the study was underpowered to detect a difference. Larger multicenter trials are required to evaluate the efficacy of gabapentin to reduce opioid requirements after aSAH.
Conclusions: The simplified 7-item JUST (JUST-7) score had good predictive ability and can help healthcare providers to estimate the likelihood of different types of stroke and decide the referral hospital. PMID: 32701385 [PubMed - as supplied by publisher]
CONCLUSIONS: A pregnant woman with severe headache should undergo brain CT or magnetic resonance imaging to rule out subarachnoid hemorrhage. PMID: 32655093 [PubMed - in process]