1/15. Disappearance of a cerebral aneurysm--an unusual angiographic event.Spontaneous thrombosis of cerebral aneurysms demonstrated by angiography is infrequent. This article describes angiographically documented spontaneous thrombosis of an intracranial aneurysm at the posterior cerebral-posterior communicating artery junction in a 40-year-old woman. The initial angiogram done on 16th day after an episode of subarachnoid haemorrhage showed a medium sized aneurysm. Subsequent angiograms done on 30th, 40th and 60th day failed to demonstrate the aneurysm. The factors leading to this rare event remain obscure.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/15. Spontaneous thrombosis of an aneurysm of the middle cerebral artery with subarachnoid haemorrhage in a 6-year-old child: case report.A 6-year-old boy had a sudden onset of rupture of an aneurysm of the middle cerebral artery. Narrowing of an artery proximal to the aneurysm was shown on an angiogram taken two days after the rupture. At operation, clipping of the aneurysm prevented further bleeding. This artery thrombosed spontaneously in the postoperative period. The outcome was favourable, and the patient returned to school life. Spontaneous thrombosis of an artery after subarachnoid haemorrhage in children is rare, and thrombosis of aneurysm is very rare. To our knowledge, this is the third reported case of spontaneous thrombosis of a cerebral saccular aneurysm with subarachnoid haemorrhage.- - - - - - - - - - ranking = 6keywords = haemorrhage (Clic here for more details about this article) |
3/15. Putaminal haemorrhage after recanalization of an embolic MCA occlusion treated with tissue plasminogen activator.We present the case of a 42-year-old female, who suffered an embolic occlusion of the right middle cerebral artery (MCA). Recanalization was achieved with tissue plasminogen activator (t-PA) within 7 h after onset of stroke. Post-t-PA infusion angiographic and CT examinations revealed fragmentation of the thrombus and a small putaminal haemorrhage associated with early reperfusion of the MCA. No clinical deterioration was observed and complete recovery occurred within 10 days.- - - - - - - - - - ranking = 5keywords = haemorrhage (Clic here for more details about this article) |
4/15. Clinical presentations of vascular malformations of the brain stem: comparison of angiographically positive and negative types.Clinical and radiographic features of 63 patients with a vascular malformation of the brain stem are described. On radiological grounds they were divided into two groups: one with angiographically visible lesions (AVAVMs), the other with lesions not seen angiographically, that is, occult (AOVMs). In the first group the initial clinical manifestation was due to haemorrhage in 20 of the 33 cases and consisted of a progressive neurological deficit in 12. In the second group 29 of the 30 initially presented with a brain stem haemorrhage. The latter was often characterised by development of symptoms over two days or more (16 cases), absence of headache (48 cases) and tendency to recurrence (20 cases). Clinical diagnosis was difficult in many cases especially in the AOVM group. Several of the patients were misdiagnosed as having multiple sclerosis. Clinical data in conjunction with magnetic resonance imaging were helpful in determining the nature of these lesions.- - - - - - - - - - ranking = 2keywords = haemorrhage (Clic here for more details about this article) |
5/15. The diagnosis and management of cerebral embolism and haemorrhagic infarction with sequential computerized cranial tomography.Haemorrhagic infarction is typically not present immediately after cerebral embolism. Spontaneous haemorrhagic transformation evolves over several days. As a consequence, delayed CT scans are essential to exclude haemorrhagic infarction before initiating anticoagulant therapy. Sequential CT scanning can also help in the diagnosis of cerebral embolism in patients with stroke of unknown cause. In such cases the detection of haemorrhagic infarction on a delayed scan suggest an embolic mechanism. The evolution of haemorrhagic infarction on sequential CT scans graphically demonstrates the dynamic nature of this lesion and thereby indicates why serious brain haemorrhage may result from anticoagulation immediately after cerebral embolism.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
6/15. Cerebral haemorrhagic infarction in young patients with hereditary protein c deficiency: evidence for "spontaneous" cerebral venous thrombosis.Among 53 patients with hereditary protein c deficiency belonging to 20 families three women were encountered who, aged 27, 34, and 38 respectively, had had cerebral haemorrhagic infarction, probably due to intracranial venous thrombosis. All three had also had venous thrombosis of the leg and pulmonary embolism either before or after their cerebral infarction. One patient sustained cerebral infarction while receiving an oral contraceptive, but infarction in the two others occurred "spontaneously." One patient also had an intraventricular and subarachnoid haemorrhage during the induction phase of coumarin treatment, which was assumed to have resulted from haemorrhagic infarction of the chorioid plexus, analogous to coumarin provoked haemorrhagic skin necrosis in protein c deficiency. Hereditary protein c deficiency should be considered in young patients with acute or subacute cerebral symptoms, especially if they have a family or personal history of venous thromboembolism.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
7/15. Spontaneous disappearance of intracranial arterio-venous malformations.4 cases of spontaneous disappearance of intracranial arteriovenous malformations are reported. All the malformations were in the rolandic-parietal area, and fed in most cases by the MCA. In one case, the malformation was associated with a proximal aneurysm. One malformation was large, one medium-sized, and two small. Venous drainage was towards the longitudinal sinus in all cases. Presenting symptoms consisted of epilepsy in 2 cases, and intracerebral haemorrhage in 2 cases. Disappearance of the AVM was documented by angiography from 1 to 15 years after diagnosis, and was preceded by a new haemorrhage in 2 cases. Acute or gradual thrombosis of the AVM is suggested as the most likely cause of the disappearance of an AVM. Spontaneous thrombosis of an AVM should be considered as an aspect of the pathological entity known as "thrombosed AVM". Guidelines for the management of patients exhibiting spontaneous disappearance of an AVM are briefly discussed.- - - - - - - - - - ranking = 2keywords = haemorrhage (Clic here for more details about this article) |
8/15. The stroke syndrome of long intraluminal clot with incomplete vessel obstruction.A stroke syndrome is described in 3 patients where long intraluminal clot formation with incomplete vessel obstruction was seen angiographically. The vessel involved in 2 cases were carotid arteries and in the third a vertebral artery. The intervening phase of long clot formation may be a feature of many cases of complete vessel occlusion. The common features of the syndrome were vessel tenderness (carotidynia in 2 cases, and vertebral artery tenderness in the third), vascular headache, the presence of subintimal haemorrhage as an anchor point for the clot, and the recurrence of clinical events. Surgical removal of these clots were successfully undertaken in each case at the acute stage.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
9/15. Leukoencephalopathy associated with extensive burns.Unusual neuropathological changes were observed in two cases following extensive burns. These consisted of perivascular areas of demyelination distributed symmetrically in the brain and affecting the white matter predominantly. One case in addition had widespread petecchial and ring haemorrhages characteristic of brain purpura. Both patients sustained second and third degree burns in greater than 50% of the body surface area, developed metabolic acidosis, sepsis, disturbance in consciousness and multiple episodes of cardiorespiratory arrest prior to death. A toxic metabolic state related to a burn toxin released from the damaged tissue or from bacterial action to the tissue in addition to low platelet level is proposed as the major pathogenetic factor in the development of the neurological symptoms and the patients' demise.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
10/15. Elusive blood clots and fluctuating ventricular dilatation after neonatal intraventricular haemorrhage.Two cases are described of a previously unrecognised sequel of posthaemorrhagic ventricular dilatation. The first case documents freely mobile blood clots within the lateral ventricular system, the second variable asymmetry in the size of the dilated lateral ventricle. The unilateral ventricular dilatation depended on which side the infant was lying, the dependent ventricle being considerably larger than the upper one within 4 hours of head turning. Each of these conditions spontaneously resolved with no specific treatment.- - - - - - - - - - ranking = 4keywords = haemorrhage (Clic here for more details about this article) |
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