Superior Hypophyseal Artery Ruptured Aneurysm in a 5-Month-Old Child Presenting as an Acute Subdural Hematoma: A Case Report

2020 ◽  
pp. 1-6
Author(s):  
Piotr Komuński ◽  
Emilia Nowosławska ◽  
Krzysztof Zakrzewski ◽  
Bartosz Polis ◽  
Wojciech Świątnicki
Keyword(s):  
Case Report ◽  
Subdural Hematoma ◽  
Mass Effect ◽  
Ruptured Aneurysm ◽  
Treatment Modalities ◽  
Acute Subdural Hematoma ◽  
Clot Removal ◽  
Right Cerebral Hemisphere ◽  
The Right ◽  
Significant Mass Effect

<b><i>Introduction:</i></b> We present a very rare case of ruptured superior hypophyseal artery (SHA) aneurysm that presented as an acute subdural hematoma (SDH) discussing its initial presentation, diagnosis, and treatment modalities. To our knowledge it is one of very few if any cases of a ruptured aneurysm in infants regarding that specific vascular location. <b><i>Case Report:</i></b> A 5-month-old boy was referred to our department due to acute SDH over the right cerebral hemisphere without significant mass effect nor hydrocephalus. Further evaluation revealed a right internal carotid artery (ICA) aneurysm arising from the SHA segment. Microsurgical clip ligation using a fenestrated, angled clip was performed with simultaneous subdural clot removal and proximal control of the ICA dissected in the neck. Our patient made an excellent recovery without any complicating features. <b><i>Conclusion:</i></b> Surgical management seems to be a better option in this subgroup of patients given the long life expectancy and durability of microsurgical clip ligation. We believe that our brief case report would add some insight into the management of this rare subgroup of patients, leading to better decision-making and outcome.

Case report: acute subdural hematoma due to angiographically unvisualized ruptured aneurysm

2005 ◽  
Vol 64 (2) ◽  
pp. 144-146 ◽  
Author(s):  
Emiko Hori ◽  
Tsuneaki Ogiichi ◽  
Nakamasa Hayashi ◽  
Naoya Kuwayama ◽  
Shunro Endo
Keyword(s):  
Case Report ◽  
Subdural Hematoma ◽  
Ruptured Aneurysm ◽  
Acute Subdural Hematoma

scholarly journals Management of Patients Presenting with Acute Subdural Hematoma due to Ruptured Intracranial Aneurysm

2012 ◽  
Vol 2012 ◽  
pp. 1-19 ◽  
Author(s):  
Serge Marbacher ◽  
Ottavio Tomasi ◽  
Javier Fandino
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Subdural Hematoma ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Mass Effect ◽  
Aneurysm Rupture ◽  
Treatment Modalities ◽  
Acute Subdural Hematoma ◽  
Rare Presentation ◽  
Ruptured Intracranial Aneurysm ◽  
Threatening Condition

Acute subdural hematoma is a rare presentation of ruptured aneurysms. The rarity of the disease makes it difficult to establish reliable clinical guidelines. Many patients present comatose and differential diagnosis is complicated due to aneurysm rupture results in or mimics traumatic brain injury. Fast decision-making is required to treat this life-threatening condition. Determining initial diagnostic studies, as well as making treatment decisions, can be complicated by rapid deterioration of the patient, and the mixture of symptoms due to the subarachnoid hemorrhage or mass effect of the hematoma. This paper reviews initial clinical and radiological findings, diagnostic approaches, treatment modalities, and outcome of patients presenting with aneurysmal subarachnoid hemorrhage complicated by acute subdural hematoma. Clinical strategies used by several authors over the past 20 years are discussed and summarized in a proposed treatment flowchart.

scholarly journals Value of Adding Cisternostomy to Decompressive Hemicraniectomy in the Management of Traumatic Acute Subdural Hematoma Patients

2020 ◽  
Vol 8 (B) ◽  
pp. 1014-1022
Author(s):  
Omar Youssef ◽  
Taher M. Ali ◽  
Khaled Anbar ◽  
Osama El-Shahawy ◽  
Abdelrhman Enayet
Keyword(s):  
Subdural Hematoma ◽  
Mass Effect ◽  
University Hospital ◽  
Neurological Deficits ◽  
Acute Subdural Hematoma ◽  
Inclusion Criteria ◽  
Decompressive Hemicraniectomy ◽  
Decompressive Craniotomy ◽  
Significant Mass Effect ◽  
Significant Mass

BACKGROUND: Surgical evacuation of acute subdural hematoma has remained the mainstay of the treatment for acute subdural hematoma (ASDH) in patients with progressive neurological deficits, increasing intracranial pressure (ICP), or significant mass effect. Cisternostomy entails opening the basal cisterns aiming to their opening to atmospheric pressure and therefore reducing the intraparenchymal pressure. AIM: We aimed to evaluate value of adding cisternostomy to decompressive craniotomy on outcome of traumatic ASDH patients. METHODS: Prospective study included 40 patients who presented to Cairo University hospital emergency department with traumatic acute subdural hematoma in the period between January 2018 and June 2019 and matching our inclusion criteria: Age from 12 to 65 years, traumatic acute subdural hematoma with thickness ≥ 10 mm or midline shift ≥ 5 mm, and Glasgow Coma Scale (GCS) on admission < 10, with no associated intraparenchymal hematoma ≥ 1 cm or severe comorbidities. Patients were randomized into one of two groups according to their order of coming. The first group patients were operated on by decompressive craniotomy (DHC) plus cisternostomy and the second group was operated on by decompressive craniotomy only. Glasgow Outcome Score (GOS) was used for outcome assessment. RESULTS: Outcome was better 2nd but not statistically significant – in the first group (DHC+ cisternostomy) in terms of mortality: 7/20 patients (35%) (p = 0.337) and median GOS: 3 (p = 0.337), compared to the second group (DHC only) in which mortality occurred in 10/20 (50%) and median GOS was 1. Adding cisternostomy to decompressive craniotomy increased surgery time with 35.5 minutes in average. In our study, older age and lower GCS on admission had significantly worse outcome. CONCLUSION: Adding cisternostomy to decompressive craniotomy in traumatic patients had better 2nd but not statistically significant outcome. Whether it should replace the routine decompressive craniotomy in these cases or not needs further larger clinical trials.

scholarly journals Acute subdural hematoma post ventricular puncture in infants: A case report and review of the literature

2021 ◽  
Vol 82 ◽  
pp. 105913
Author(s):  
El Hadji Cheikh Ndiaye Sy ◽  
Yakhya Cisse ◽  
Jean Michel Nzisabira ◽  
Ansoumane Donzo ◽  
Pape Sandene Ndiaye ◽  
...  
Keyword(s):  
Case Report ◽  
Subdural Hematoma ◽  
Acute Subdural Hematoma ◽  
Review Of The Literature ◽  
Ventricular Puncture

scholarly journals Kernohan-Woltman notch phenomenon and intention tremors in case of chronic subdural hematoma

2014 ◽  
Vol 21 (1) ◽  
pp. 109-112
Author(s):  
P. Sasikala ◽  
Bindu Menon ◽  
Amit Agarwal
Keyword(s):  
Ct Scan ◽  
Movement Disorders ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Mass Effect ◽  
Midline Shift ◽  
Rare Presentation ◽  
Surgical Evacuation ◽  
Significant Mass Effect ◽  
Significant Mass

Abstract Movement disorders are atypical and rare presentation of chronic subdural hematomas. We report a case of 60 year man who presented with intention tremors and altered sensorium. The patient had Kernohan-Woltman notch phenomenon on clinical examination. CT scan brain showed a large left fronto-temporo-parietal chronic subdural hematoma with significant mass effect and midline shift. His symptoms relieved completely after surgical evacuation of the hematoma.

scholarly journals Clinical-enabled aspects after Neurotoxoplasmosis in a patient with immunosuppression: a case report

2021 ◽  
Author(s):  
Adrielle Galanti ◽  
Verônia Corrêa César Rodrigues ◽  
Daniela Maria Ribeiro Vaz ◽  
Ana Paula Oliveira Borges
Keyword(s):  
Case Report ◽  
Motor Coordination ◽  
Clinical Investigation ◽  
Functional Independence ◽  
Berg Balance Scale ◽  
Fine Motor ◽  
Cross Sectional ◽  
Right Cerebral Hemisphere ◽  
The Right ◽  
Immunodeficiency Syndrome

Background: Neurotoxoplasmosis is an opportunistic infection caused by the protozoan Toxoplasma Gondii, frequent in patients with Acquired Immunodeficiency Syndrome who become immunosuppressed by the presence of the disease. It can be presented by one or more brain abscesses, encephalitis or ventriculitis. Objectives: case report of a volunteer after neurological sequelae of neurotoxoplasmosis in order to highlight the relevant findings for a neurofunctional rehabilitation. Design and setting: This is an observational, cross-sectional case report type study conducted at the Clínica Escola de Fisioterapia of the University of Franca (UNIFRAN), with CEP approval (CAAE 83164918.2.0000.5495). Methods: Female patient, 53 years old. In the physiotherapy sector, neurological evaluation of the components was performed: sensitivity, movement, tone, reflexes, motor coordination, balance and gait. Balance and gait were assessed using the Berg Balance Scale, the Standing and Walking Test and the Dynamic Walking Index. Results: After clinical investigation, neurological toxoplasmosis infection was found in the right cerebral hemisphere. The physiotherapeutic evaluation showed the presence of left hemiparesis, the presence of spastic hypertonia, patellar and achilles hyperreflexia, the absence of fine motor skills and the presence of a reaping gait. The BSE result was 32 points, the TUG was 10.3 seconds and IMD was 20 points. Conclusion: The compromises found have an impact on the functionality of the volunteer. This study emphasizes the valorization of neurofunctional physiotherapeutic semiology for a treatment proposal that promotes greater functional independence.

Spontaneous resolution of invasive cerebral aspergillosis following partial resection in a medically untreated infant

2012 ◽  
Vol 10 (1) ◽  
pp. 71-74 ◽  
Author(s):  
Sumit Thakar ◽  
Yasha T. Chickabasaviah ◽  
Alangar S. Hegde
Keyword(s):  
Emergency Services ◽  
Mass Effect ◽  
Cerebral Hemiatrophy ◽  
Right Cerebral Hemisphere ◽  
History Of ◽  
Subcortical Regions ◽  
The Right ◽  
Mri Study ◽  
The Brain

Invasive craniocerebral aspergillosis, often encountered in an immunocompromised setting, is almost uniformly fatal despite radical surgical and medical management, and is frequently a necropsy finding. The authors report a unique, self-resolving clinical course of this aggressive infection in a 10-month-old infant. The infant was brought to the emergency services in altered sensorium with a 1-week history of left-sided hemiparesis, excessive irritability, and vomiting. An MRI study of the brain revealed multiple, heterogeneously enhancing lesions in the right cerebral hemisphere with mass effect. The largest lesion in the frontotemporal cortical and subcortical regions was decompressed on an emergent basis. Histopathological findings were suggestive of invasive aspergillosis, although there was no evidence of the infection in the lungs or paranasal sinuses. Computed tomography–guided aspiration of the remaining lesions and follow-up antifungal therapy were recommended. The parents, however, requested discharge without further treatment. The child was seen at a follow-up visit 3 years later without having received any antifungal treatment. Imaging showed resolution of the infection and features of Dyke-Davidoff-Masson syndrome (cerebral hemiatrophy). This report of invasive cerebral aspergillosis resolving without medical therapy is the first of its kind. Its clinicoradiological aspects are discussed in light of previously reported cases.

Acute Subdural Hematoma with Rapid Resolution in Infancy: Case Report

Neurosurgery ◽  
1986 ◽  
Vol 19 (3) ◽  
pp. 465-467 ◽  
Author(s):  
Takeki Nagao ◽  
Nobuhiko Aoki ◽  
Hiroshi Mizutani ◽  
Koichi Kitamura
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Subdural Hematoma ◽  
Acute Subdural Hematoma ◽  
Minor Head Trauma ◽  
Arachnoid Membrane ◽  
Rapid Resolution ◽  
Computed Tomographic ◽  
Nonsurgical Management ◽  
Short Period

Abstract An infant who suffered acute subdural hematoma due to minor head trauma twice in a short period is presented. Each subdural hematoma, showing high density on computed tomographic scanning, resolved with unusual rapidity, resulting in full recovery after nonsurgical management. The mechanism of this rapid resolution of each hematoma was thought to be participation of cerebrospinal fluid secondary to a tearing of the arachnoid membrane.

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