1/12. Late detection of supraclinoid carotid artery aneurysm after traumatic subarachnoid hemorrhage and occlusion of the ipsilateral cervical internal carotid artery.BACKGROUND AND PURPOSE: We report the first case of traumatic aneurysm of the supraclinoid internal carotid artery (ICA), which we speculate may have developed or grown after traumatic occlusion of the ipsilateral cervical ICA. CASE DESCRIPTION: A 26-year-old man presented with severe traumatic subarachnoid hemorrhage (SAH) and occlusion of the right cervical ICA after a motor vehicle accident. Three-dimensional CT angiography on admission showed no aneurysm. However, cerebral angiography 3 weeks after the injury showed a large aneurysm of the right supraclinoid ICA. The aneurysm was trapped, and pathological examination showed that it was a traumatic aneurysm. CONCLUSIONS: In this case we cannot be sure that the aneurysm was not present on admission. In view of the significant SAH, a lesson of this case may be to suspect such an aneurysm early on and perform early diagnostic cerebral angiography.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
2/12. Identification of an arteriovenous fistula in a child. Case report and review of the literature.BACKGROUND: A 6-year-old girl sustained a subarachnoid hemorrhage after a mild head injury and was discovered to have an arteriovenous fistula (AVF). INVESTIGATIONS AND TREATMENT: The etiology of subarachnoid hemorrhage was not evident on the initial brain CT. Brain CT with CT angiography identified the lesion. The AVF was further imaged with brain MRI followed by cerebral angiography and successfully embolized. OUTCOME: The child did not suffer any neurological sequelae.- - - - - - - - - - ranking = 0.4keywords = subarachnoid (Clic here for more details about this article) |
3/12. Traumatic subarachnoid-pleural fistula in children. Report of 2 cases and review of the literature.Traumatic subarachnoid-pleural fistula (TSAPF) is a rare complication of thoracic trauma. Late diagnosis is a problematic dilemma in these cases. patients with thoracic injury have persistent pleural leakage, thoracic vertebral injury, pneumocephalus, urinary retention and paraplegia should alert the surgeon for TSAPF. Two cases of TSAPF due to gunshot injury are reported.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
4/12. Mycotic cerebral vasculitis in a paediatric cardiac transplant patient excludes misadventure.We present the case of a 10-year-old girl with cardiomyopathy who received a heart transplant. Due to organ rejection, the dosage of immunosuppressive agents was increased postoperatively. The patient complained of intermittent headaches in the following days and developed a haemorrhagic necrosis of the left thalamus. A week later, an oral dose of cyclosporin A was accidentally given intravenously, and 2 weeks later a recurrent subarachnoid haemorrhage of unknown origin was diagnosed. The clinical course was then characterised by progressive deterioration resulting in coma, fluctuating brain stem symptoms and the development of a massive cerebral oedema with subsequent brain death. A coroner's autopsy was instigated to investigate a claim of medical misadventure. Neuropathological investigations found a focal infiltration of fungal hyphae in the left posterior cerebral artery resulting in necrosis of the vascular wall and thus explaining the source of the recurrent subarachnoid haemorrhage which eventually resulted in the girl's death. Medical misadventure due to the administration of cyclosporin was not directly responsible for the death of this patient. This case illustrates that it is of paramount importance to copiously sample and investigate the basal cerebral arteries in cases of subarachnoid haemorrhage of unknown origin, in particular in a medico-legal context.- - - - - - - - - - ranking = 2.4259730234604keywords = subarachnoid haemorrhage, subarachnoid, haemorrhage (Clic here for more details about this article) |
5/12. papaverine angioplasty to treat cerebral vasospasm following traumatic subarachnoid haemorrhage.The management of vasospasm associated with traumatic subarachnoid haemorrhage presents many challenges. We present a 20-year-old male admitted after sustaining a closed head injury complicated by a Fisher grade III traumatic subarachnoid haemorrhage. Despite treatment with intravenous nimodipine he developed a delayed ischaemic neurological deficit due to cerebral arterial vasospasm. The vasospasm was successfully managed with serial papaverine angioplasty.- - - - - - - - - - ranking = 4.8519460469208keywords = subarachnoid haemorrhage, subarachnoid, haemorrhage (Clic here for more details about this article) |
6/12. Traumatic basal subarachnoid haemorrhage caused by the impact of a golf ball: a case report.A 50-year-old male was hit by a high-speed golf ball on the left lateral side of his neck. He collapsed immediately and was sent to hospital, where he was pronounced dead. The autopsy showed an extensive basal subarachnoid haemorrhage. Careful gross and histological examinations disclosed a rupture of the right vertebral artery at a site very close to the bifurcation. It was estimated that the impact of the golf ball on the left side of his neck resulted in the rupture of the contralateral vertebral artery, owing to its hyperextension. Although there are many reports on traumatic basal subarachnoid haemorrhage, the present type of trauma seems rare to our knowledge.- - - - - - - - - - ranking = 4.8519460469208keywords = subarachnoid haemorrhage, subarachnoid, haemorrhage (Clic here for more details about this article) |
7/12. Traumatic subarachnoid hemorrhage and extracranial vertebral artery injury: a case report and review of the literature.The case is presented of a 19-year-old man who was assaulted and died shortly afterward from a large traumatic basal subarachnoid hemorrhage (TBSAH) that arose from rupture of the left vertebral artery, proximal to the point at which the artery penetrated the dura. The literature regarding TBSAH and vertebral artery rupture is reviewed, and a number of points are highlighted: patients with TBSAH may remain conscious for a period of hours after injury, subcutaneous or muscular bruising may be contralateral to the ruptured vessel, fractures of the transverse processes of the cervical vertebrae and significant pathology of the vertebral artery are not typically associated with TBSAH, and rupture of the vertebral artery may be intracranial, junctional, or extracranial.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
8/12. Medicolegal diagnostic value and clinical significance of traumatic incomplete tears of the basilar artery.Ruptures of arteries of the vertebrobasilary system are relatively frequent in medicolegal practice, and their origin may be both natural and violent. tears that affects the whole thickness of the basilar artery cause subarachnoid hemorrhage (SAH), with an often rapid fatal outcome. 1-3 However, in some situations, arterial tears may be incomplete, involving the intima or both the intima and the media, but with preserved adventitia. 1, 4 Although such incomplete tears are not the source of immediate subarachnoid bleeding, their presence may be important from both a medicolegal and a clinical point of view.The aim of this article is to point out the significance of incomplete tears of basilar artery as a possible diagnostic sign of traumatic origin of SAH as well as a certain mechanism of injury, which involves forcible hyperextension and rotational movements of the head. The authors also describe their method of performing longitudinal section of the basilar artery, both at autopsy and for histologic examination, which is convenient for identifying multiple transversal incomplete tears of this blood vessel. The article is based on the analysis of three cases from the autopsy material of the Institute of forensic medicine in Belgrade.- - - - - - - - - - ranking = 0.4keywords = subarachnoid (Clic here for more details about this article) |
9/12. Hyperextension and rotation of head causing internal carotid artery laceration with basilar subarachnoid hematoma.Hyperextension of the head can cause injury to the vessels at the base of the brain. These lacerations are believed to be caused by stretching of the vessels due to the abrupt movement of the head and rotational acceleration of the brain within the cranium, and they usually occur in the intracranial portions of the vessels, producing a subarachnoid hemorrhage. This is the case of a 35-year-old man who received a blow to the face that forcefully hyperextended and rotated his head to the left. autopsy revealed an intracranial right internal carotid laceration extending from a calcified atherosclerotic plaque. This unusual injury may be due to a combination of blunt force applied to the head and the alteration of the vessel's structural and functional capacities secondary to atherosclerosis.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
10/12. Superficial siderosis of the central nervous system following cervical nerve root avulsion: the importance of early diagnosis and surgery.Superficial siderosis (SS) of the central nervous system is an insidious, progressive, irreversible and debilitating neurological disorder caused by recurrent haemorrhage within the subarachnoid space. The subsequent deposition of haemorrhagic breakdown products in the spinal cord and nervous tissues leads to the loss of neurones and myelin, and to the development of a neurological deficit. In a small number of patients, the source of haemorrhage is related to traumatic cervical nerve root avulsion occurring several years prior to the onset of symptoms. Surgical ablation of the source has been shown to halt the progression of the disease, at least in the short term. We review the literature on SS secondary to cervical nerve root avulsion and report a further case in which surgical management was successful in halting disease progression. We emphasize that early detection and recognition of the initial non-progressive symptoms related to this poorly known disease, coupled with timely surgical management, minimizes the degree of neurological disability.- - - - - - - - - - ranking = 0.21756596423046keywords = subarachnoid, haemorrhage (Clic here for more details about this article) |
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