The use of computed tomography in the prediction of delayed cerebral infarction following acute aneurysm surgery for subarachnoid haemorrhage

1995 ◽  
Vol 132 (1-3) ◽  
pp. 9-13 ◽  
Author(s):  
Y. Hirashima ◽  
M. Kurimoto ◽  
M. Takaba ◽  
S. Endo ◽  
A. Takaku
Keyword(s):  
Computed Tomography ◽  
Cerebral Infarction ◽  
Subarachnoid Haemorrhage ◽  
Aneurysm Surgery

Value of Computed Tomography in the Diagnosis and Management of Subarachnoid Hemorrhage

Neurosurgery ◽  
1978 ◽  
Vol 3 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Luciano M. Modesti ◽  
Eugene F. Binet
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Cerebral Infarction ◽  
Poor Prognosis ◽  
Diagnostic Value ◽  
Effective Management ◽  
Aneurysm Surgery ◽  
Before And After ◽  
Serial Scanning ◽  
Spontaneous Subarachnoid Hemorrhage

Abstract The diagnostic value of computed tomography is analyzed in 31 patients with documented spontaneous subarachnoid hemorrhage. In 50% of all cases, the computed tomogram confirmed the presence of subarachnoid hemorrhage. This figure rose to 68% for cooperative patients examined within 24 hours of their ictus. With enhanced tomography the responsible aneurysm was identified in 30% of the cases. The distribution of the subarachnoid hemorrhage correctly predicted the location of the aneurysm in an additional 35%. Intracerebral or intraventricular hemorrhages were present in 35%. They occurred most frequently within the first 24 hours, were most commonly associated with ruptured anterior communicating aneurysms, and carried a poor prognosis. Cerebral infarction was demonstrated in five patients. Ventricular dilatation was present in 11 (63%) of the 19 patients who were examined during the first 24 hours after the hemorrhage. Seven patients showed progressive hydrocephalus on serial scanning. Shunting before aneurysm surgery was required in four cases. Computed tomography is the procedure of choice for the detection of intracerebral and intraventricular hemorrhage and cerebral infarction: it is superior to angiography in this respect. Computed tomography is also helpful in detecting the presence of subarachnoid hemorrhage and determining ventricular size. Frequently the offending aneurysm can be identified or its location can be accurately predicted, allowing more effective management. We recommend that a computerized tomographic scan be performed (preferably within 24 hours of the ictus) on all patients suspected of having had a subarachnoid hemorrhage. The studies should be done before and after enhancement with a contrast medium.

scholarly journals Aneurysm Arising at the Origin of a Duplicated Middle Cerebral Artery

2021 ◽  
pp. 446-450
Author(s):  
Jean Roch Alliez ◽  
Luis Manera
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Haemorrhage ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
World Federation ◽  
Treatment Procedure ◽  
3D Computed Tomography ◽  
Ruptured Aneurysms ◽  
Tomography Reconstruction ◽  
Computed Tomography Reconstruction

A duplicated middle cerebral artery (DMCA) is a common anomaly. However, aneurysms arising from the origin of a DMCA are extremely rare. A 22-year-old female was admitted to our hospital with a World Federation of Neurosurgical Societies grade 2 subarachnoid haemorrhage. Four-vessel angiography revealed a DMCA and an aneurysm arising from the origin of this artery. The aneurysm was successfully treated by embolization, and the patient was discharged 2 weeks later. Ruptured aneurysms arising from the origin of a DMCA can be successfully treated by embolization. These aneurysms are small and 3D-computed tomography reconstruction is mandatory to detect them. It is important to preserve the DMCA during the treatment procedure.

scholarly journals Delayed lumbar plexus palsy due to giant psoas hematoma associated with vertebral compression fracture and direct oral anticoagulants: a case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chikako Ishii ◽  
Miki Komatsu ◽  
Kota Suda ◽  
Masahiko Takahata ◽  
Satoko Matsumoto Harmon ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Atrial Fibrillation ◽  
Cerebral Infarction ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Lumbar Plexus ◽  
Vertebral Compression Fractures ◽  
Minimal Risk ◽  
Motor Weakness ◽  
Segmental Artery

Abstract Background Osteoporotic vertebral compression fractures (VCFs) are commonly observed in elderly people and can be treated by conservatively with minimal risk of complications in most cases. However, utilization of direct oral anticoagulants (DOACs) increases the risks of secondary hematoma even after insignificant trauma. The use of DOACs increased over the past decade because of their approval and recommendation for both stroke prevention in non-valvular atrial fibrillation and treatment of venous thromboembolism. It is well known that DOACs are safer anticoagulants than warfarin in terms of major and nonmajor bleeding; however, we noted an increase in the number of bleeding events associated with DOACs that required medical intervention. This report describes the first case of delayed lumbar plexus palsy due to DOAC-associated psoas hematoma after VCF to draw attention to potential risk of severe complication associated with this type of common and stable trauma. Case presentation An 83-year-old man presented with his left inguinal pain and inability to ambulate after falling from standing position and was prescribed DOACs for chronic atrial fibrillation. Computed tomography angiography revealed a giant psoas hematoma arising from the ruptured segmental artery running around fractured L4 vertebra. Because of motor weakness of his lower limbs and expansion of psoas hematoma revealed by contrast computed tomography on day 8 of his hospital stay, angiography aimed for transcatheter arterial embolization was tried, but could not demonstrate any major active extravasation; therefore spontaneous hemostasis was expected with heparin replacement. On day 23 of his stay, hematoma turned to decrease, but dysarthria and motor weakness due to left side cerebral infarction occurred. His pain improved and bone healing was achieved about 2 months later from his admission, however the paralysis of the left lower limb and aftereffects of cerebral infarction remained after 1 year. Conclusion In patients using DOACs with multiple risk factors, close attention must be taken in vertebral injury even if the fracture itself is a stable-type such as VCF, because segmental artery injury may cause massive psoas hematoma followed by lumbar plexus palsy and other complications.

Outcome in patients with subarachnoid haemorrhage and negative angiography according to pattern of haemorrhage on computed tomography

The Lancet ◽  
1991 ◽  
Vol 338 (8773) ◽  
pp. 964-968 ◽  
Author(s):  
G.J.E Rinkel ◽  
E.F.M Wijdicks ◽  
J van Gijn ◽  
D Hasan ◽  
M Vermeulen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Haemorrhage ◽  
Negative Angiography

scholarly journals Cerebral Infarction Along the Distribution of Perforating Arteries During Aneurysm Surgery in a Patient With Pheochromocytoma

2011 ◽  
Vol 51 (1) ◽  
pp. 72-75
Author(s):  
Nobusuke TSUZUKI ◽  
Hiroshi NAWASHIRO ◽  
Terushige TOYOOKA ◽  
Hideo OSADA ◽  
Naoki OTANI ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Aneurysm Surgery ◽  
Perforating Arteries

Nimodipine for delayed cerebral ischaemia after subarachnoid haemorrhage

1992 ◽  
Vol 30 (21) ◽  
pp. 81-83 ◽  
Keyword(s):  
Calcium Antagonist ◽  
Cerebral Infarction ◽  
Subarachnoid Haemorrhage ◽  
Cerebral Ischaemia ◽  
Neurological Outcome ◽  
Initial Phase ◽  
Morbidity And Mortality ◽  
Delayed Cerebral Ischaemia

Subarachnoid haemorrhage (SAH) occurs in about one in every 1000 adults.1 Left untreated, around one third of people with an SAH die within 3 days of the initial bleed. Of those who survive the initial phase many go on to develop ‘delayed’ cerebral ischaemia, which itself is associated with cerebral infarction and an increase in morbidity and mortality. The calcium antagonist nimodipine (Nimotop – Bayer) is promoted as a drug that “reduces cerebral infarction and improves neurological outcome in SAH”. How effective is it?

The Capacity for Computed Tomography Diagnosis of Cerebral Infarction

Radiology ◽  
1977 ◽  
Vol 125 (2) ◽  
pp. 393-402 ◽  
Author(s):  
Burton P. Drayer ◽  
Manuel Dujovny ◽  
Manfred Boehnke ◽  
Sidney K. Wolfson ◽  
Pedro J. Barrionuevo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cerebral Infarction ◽  
Computed Tomography Diagnosis
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