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Le Roux P D - - 1998
Rupture of cerebral aneurysms is a complex and devastating pathophysiologic event. The successful management of aneurysm rupture requires a dedicated multidisciplinary team. This article reviews pathophysiology; clinical grading that can be used to predict outcome and guide therapy; factors that may affect outcome such as rebleeding, poor clinical grade, intracerebral ...
Oei P L - - 1998
Angiographic embolization is a well documented technique that has been utilized for controlling pelvic hemorrhage. A case is described of a 41-year-old para 3 woman with intractable bleeding following a cesarean hysterectomy for postpartum hemorrhage due to uterine atony and coagulopathy. On angiogram, no bleeding was seen from the uterine ...
Okada Y - - 1998
A 62-year-old male complaining of unilateral visual disturbance and pain in the involved eye had a small mass at the right orbital apex which was identified as an Aspergillus granuloma by transcranial biopsy. One month later, the patient became comatose because of fatal subarachnoid hemorrhage due to a newly developed ...
Todo H - - 1998
The authors investigated the changes and the potential of cyclic nucleotide-dependent signal transduction, which induces smooth muscle relaxation, in the basilar artery with severe vasospasm in dogs with double experimental subarachnoid hemorrhage (SAH) to explore at which biochemical level the arterial dilative capability was impaired. The amount of cyclic adenosine ...
Marshman L A - - 1998
Sodium nitroprusside (SNP) is commonly used for controlled systemic hypotension during aneurysm surgery after acute subarachnoid hemorrhage (SAH). Few experimental studies have assessed cerebrovascular responsiveness to SNP acutely after a representative SAH (i.e., following arterial rupture within the subarachnoid space). Instead, most studies have focused on delayed reactivity after slow ...
Berdoz D - - 1998
The clinical and radiological data of 52 patients with subarachnoid haemorrhage (SAH) and a negative panangiography were analysed with an average follow-up period of 3.8 years. Of these 52 patients, only one (1.9%) was subsequently found to have an aneurysm. Second angiography proved to be inconclusive in all 24 cases ...
Kalinowski E A - - 1998
A patient developed retroperitoneal hemorrhage after cardiac catheterization, initially thought to be a complication of the puncture. Diagnostic evaluation revealed the source to be spontaneous bleeding from a lumber artery, which was successfully embolized. Spontaneous hemorrhage is a recognized complication of anticoagulation therapy and must be considered in the differential ...
Kachhara R - - 1998
A 50-year-old female presented with rare fenestration of the proximal anterior cerebral artery (A1 segment). This rare congenital anomaly was associated with an aneurysm at the proximal end of A1 fenestration causing subarachnoid hemorrhage, and aplasia of the contralateral A1 segment. Surgical treatment to clip the aneurysm resolved her symptoms. ...
Khanlou H - - 1998
We describe two cases of diffuse alveolar hemorrhage and development of ARDS in patients who underwent percutaneous transluminal coronary angioplasty (PTCA) with stenting in whom Abciximab (ReoPro) was used in combination with other agents interfering with the hemostatic mechanism. The development of pulmonary infiltrates, associated with a fall in hemoglobin ...
Osuka K - - 1998
BACKGROUND AND PURPOSE: Inducible cyclooxygenase (COX-2) has been found to play a pathological role in cerebral insult. We investigated the expression of COX-2 in the basilar artery after experimental subarachnoid hemorrhage (SAH). METHODS: In a canine "two-hemorrhage" model of SAH, the basilar arteries were obtained on day 2 after a ...
Shen W C - - 1998
The occurrence of a subdural hematoma caused by the rupture of an intracranial aneurysm is rare. In our case, the patient is a 43-year-old woman who suffered from sudden onset of severe headache. Computed tomographic (CT) scan disclosed a subdural hematoma associated with subarachnoid hemorrhage. CT angiography and digital subtraction ...
Lam S M - - 1998
A generalized allergic reaction to or anaphylaxis from honeybee sting may involve the skin with erythema, puritus, urticaria, or angioedema; the respiratory tract with laryngeal edema, and brochospasm; the cardiovascular system with myocardial depression, hypotension, and shock; and the gastrointestinal system with nausea, vomiting, and incontinence. Acute pulmonary hemorrhage following ...
Duong D H - - 1998
PURPOSE: The purpose of this study was to define the influence of feeding mean arterial pressure (FMAP) in conjunction with other morphological or clinical risk factors in determining the probability of hemorrhagic presentation in patients with cerebral arteriovenous malformations (AVMs). METHODS: Clinical and angiographic data from 340 patients with cerebral ...
Nighoghossian N - - 1998
The occurrence of intracerebral hemorrhage during an acute attack of migraine remains questionable. A normotensive migrainous woman experienced multiple intracerebral hemorrhages. No drug abuse was recorded, but bleeding occurred after the use of several antimigrainous drugs. Angiography revealed severe vasospasm of both anterior cerebral arteries. Subsequent brain MRI and MRI ...
Bax N M - - 1998
Huge sacrococcygeal teratomas in the newborn can cause significant morbidity and even death due to cardiac failure, hemorrhage, or both. Surgical removal is the treatment of choice, but can indicate these events. Ligation of the median sacral artery, which always supplies the tumor, prior to its removal has been advocated, ...
Barksdale P A - - 1998
OBJECTIVE: To examine the current clinical problem of life-threatening hemorrhage during sacrospinous vaginal vault suspension, define a management solution, and validate current anatomic knowledge of the area involved. METHODS: Ten cadaveric female pelves were dissected from a posterior gluteal approach and from an abdominal approach. The vascularity of the region ...
Mizutani T - - 1998
BACKGROUND: It has been assumed that dissecting aneurysms presenting with subarachnoid hemorrhage (SAH) are extremely rare in the carotid circulation. This may be partially attributed to the difficulty in their diagnosis. The documented angiographic findings include arterial narrowing or occlusion. The purpose of the present study is to investigate the ...
Mori K - - 1998
Spontaneous dissecting aneurysms limited to the basilar artery are rare. We describe two patients who presented to our institution with different clinical problems, one with brain stem infarction and the other with subarachnoid hemorrhage. We describe the clinical and imaging features in these patients, their treatment, and outcome. We also ...
Zhang J - - 1998
Subarachnoid hemorrhage (SAH) resulting from the rupture of a cerebral aneurysm represents one major cause of stroke. SAH may be followed by a spontaneous severe contraction of major cerebral arteries, a condition referred to as cerebral vasospasm. Vasospasm may result in brain ischemia or actual tissue death. This constrictive vascular ...
Tommasino C - - 1998
Cerebral vasospasm following aneurysmal subarachnoid hemorrhage is one of the most important causes of cerebral ischemia, and is the leading cause of death and disability after aneurysmal rupture. The optimal treatment of vasospasm awaits development of agents for blocking or inactivating spasmogenic substances, or blocking arterial smooth muscle contraction. Rheological ...
Rabb C H - - 1998
OBJECTIVE AND IMPORTANCE: Two patients with vertebrobasilar dolichoectasia sustained massive fatal subarachnoid hemorrhage from rupture of the basilar artery wall. Hemorrhage from this entity is not widely known to occur during its natural history and may be exacerbated by systemic anticoagulation. CLINICAL PRESENTATION: Two patients presented with ischemic events of ...
Cuevas P - - 1998
BACKGROUND: In animal models of subarachnoid hemorrhage (SAH), basilar artery spasm has been described. Since fibroblast growth factors (FGFs) dilate rat basilar artery in vivo, we tested whether systemic administration of acidic fibroblast growth factor (aFGF) can reverse the basilar artery spasm following rat SAH. METHODS: SAH was mimicked by ...
Han D H - - 1998
Sixteen patients with the diagnosis of vertebral or basilar artery dissection who were admitted at the Seoul National University Hospital from 1972 to 1996 are described. During the same period, we encountered 76 patients with posterior circulation aneurysms, so the vertebrobasilar artery dissection was 21% of posterior circulation aneurysms. The ...
Yasui T - - 1998
OBJECTIVE AND IMPORTANCE: We present the case of a patient with bilateral dissecting aneurysms of the vertebral arteries resulting in subarachnoid hemorrhage. CLINICAL PRESENTATION: A 44-year-old man suffered a sudden onset of severe occipital headache and nausea and then dysphasia caused by subarachnoid hemorrhage. A computed tomographic scan demonstrated right ...
Urbach H - - 1998
This study was designed to assess the necessity for a second angiogram study in patients in whom initial angiography after primary subarachnoid haemorrhage (SAH) was negative. During a 12-year period, 122 of 694 patients (17.5%) had negative initial angiograms. CT, available for 98 patients, showed a preponderance of subarachnoid blood ...
Milburn J M - - 1998
OBJECT: This study was conducted to determine if there is a change in intracranial arterial diameters after papaverine infusion for vasospasm and to determine whether the change occurs in proximal, intermediate, and distal arteries. METHODS: The authors measured arterial diameters retrospectively in all patients who received intraarterial papaverine for treatment ...
Hirai S - - 1998
A retrospective study was conducted to determine the angioarchitecture related to hemorrhage in patients with cerebral arteriovenous malformations (AVMs), who underwent conservative treatment and long-term follow-up. The average observation period was 9.3 years, and the annual bleeding rate was estimated at 3.6%. In all cases angiographic findings were reviewed in ...
Liu M F - - 1998
Pulmonary hemorrhage is a rare, but serious manifestation of systemic lupus erythematosus (SLE). Herein, we report 13 cases of severe pulmonary hemorrhage in SLE. Hemoptysis was present in 11 patients. All thirteen patients had active nephritis and were in the stage of nephrotic syndrome. A majority of the patients had ...
Sarrafzadeh A S - - 1998
Continuous monitoring of cerebral metabolism would be desirable for early detection of vasospasm in SAH patients. Bedside-microdialysis, a new technique for on-line monitoring of cerebral metabolism, may reflect changes seen in cerebral vasospasm diagnosed by transcranial Doppler sonography (TCD). This report represents the first case of combined TCD monitoring and ...
Szabo S - - 1997
BACKGROUND AND PURPOSE: Vasospasm in aneurysmal subarachnoid hemorrhage results in proliferative vasculopathy. Systemic hypertension also causes vascular hypertrophy. Both of these histological changes can lead to rigidity of the cerebrovascular system, reducing its autoregulatory capacity. METHODS: Blood flow velocity (BFV) in the middle cerebral artery at rest and cerebrovascular reserve ...
Murayama Y - - 1997
Cerebral vasospasm is the most common cause of morbidity and mortality in patients admitted to the hospital after suffering aneurysmal subarachnoid hemorrhage (SAH). The early surgical removal of subarachnoid clots and irrigation of the basal cisterns have been reported to reduce the incidence of vasospasm. In contrast to surgery, the ...
McLaughlin M R - - 1997
OBJECTIVE AND IMPORTANCE: This case illustrates that although endoscopic third ventriculostomy for patients with aqueductal stenosis is successful and minimally invasive, it can have severe, life-threatening complications. CLINICAL PRESENTATION: A 3-year-old girl presented with hydrocephalus and aqueductal stenosis. She underwent endoscopic third ventriculostomy with laser fenestration of the third ventricular ...
King J T JT - - 1997
An estimated 1% to 5% of adults have a cerebral aneurysm. Each year, approximately 1 in 10,000 North Americans suffer an aneurysmal subarachnoid hemorrhage, with greater than 50% combined morbidity and mortality. Cerebral aneurysm formation and rupture is associated with a variety of factors, including increasing age, female gender, hypertension, ...
Uziel Y - - 1997
Pulmonary hemorrhage (PH) is a rare but potentially life-threatening manifestation of systemic lupus erythematosus (SLE). In this report we describe a 13 year old girl with PH as the sole presenting clinical manifestation of her SLE. Her serology was diagnostic of SLE and one year after presentation she developed arthritis. ...
Bagley L J - - 1997
This article discusses the indications for, techniques of, and risks associated with cerebral angiography. Various types of aneurysms are described, and there is a discussion of the angiographic features of aneurysms in specific locations. Subarachnoid hemorrhage, post-subarachnoid hemorrhage vasospasm, and the role of post-operative angiography are also covered.
Tamargo R J - - 1997
The prognostic features and outcomes associated with aneurysmal subarachnoid hemorrhage (SAH) are reviewed. In the first section, the epidemiology of SAH is discussed with emphasis on prevalence, incidence, risk factors, heredity, activity, and seasonal variability. In the second section, the presentation, diagnosis, and treatment of patients with aneurysmal SAH is ...
Naff N J - - 1997
Intraventricular hemorrhage (IVH) frequently occurs in the setting of intracerebral and subarachnoid hemorrhage, and is an independent and significant contributor to morbidity and mortality in both conditions. Present therapy of IVH is directed at treating the associated complications of obstructive and communicating hydrocephalus. These therapies are often inadequate to treat ...
Kluger Y - - 1997
OBJECTIVE: To describe a technique for arresting traumatic bleeding uncontrollable by conventional means. METHODS AND RESULTS: Major intrathoracic bleeding was stopped in a 17-year-old boy who had been stabbed in his right chest by using a Hemorrhage Occluder Pin (Surgical Instruments Inc., Placetia, Calif). CONCLUSIONS: The use of occluder pins ...
Orita T - - 1997
OBJECTIVE AND IMPORTANCE: We report the use of a transcortical transventricular approach to a P2 aneurysm, which was located near the choroidal fissure, protruded into the temporal horn, and was considered to be too difficult to approach by the conventional subtemporal route. CLINICAL PRESENTATION: An 81-year-old woman suddenly developed severe ...
Nussbaum E S - - 1997
BACKGROUND: Days after aneurysmal subarachnoid hemorrhage (SAH), cerebral vasospasm can result in the delayed appearance of ischemic neurological deficit identical to that produced by other causes of stroke. Despite the well-described, "classic" presentation of SAH, up to 25% of patients are initially misdiagnosed, and the initial hemorrhage from a ruptured ...
Maeda K - - 1997
The authors present two rare cases of severe cerebral vasospasm following the rupture of arteriovenous malformations (AVMs). Computerized tomography revealed intracerebral hemorrhage in the thalamus in one case and in the putamen in the other, both accompanied by cast formation of intraventricular clots without radiological evidence of subarachnoid hemorrhage. Initial ...
Schmutz F - - 1997
PURPOSE: To evaluate the safety of silk as an embolic agent for preoperative embolization of cerebral arteriovenous malformations (AVMs) by assessing the histopathologic changes and hemorrhagic complications associated with its use. METHODS: Histopathologic specimens, medical records, and radiologic records of 73 patients with AVMs embolized with silk (alone or in ...
Ono S - - 1997
BACKGROUND AND PURPOSE: Although mice, rats, and other small animals are commonly used for molecular biology research, their use in the evaluation of cerebral vasospasm after subarachnoid hemorrhage is somewhat problematic because of the correspondingly small size of their cerebral vessels. We have already reported that the corrosion cast technique ...
Ogiichi T - - 1997
A 60-year-old male presented with subarachnoid hemorrhage (SAH) of unknown origin and died of peritonitis 2 months after the ictus. Computed tomography on admission revealed localized hemorrhage at the interpedunclar cistern and sedimentation in both posterior horns. Repeat angiography could not detect any aneurysm. Postmortem histological examination revealed disruption of ...
Droste D W - - 1997
Besides the degree of carotid artery stenosis, the composition of the plaque may help to predict the thromboembolic risk. Low echogenicity on ultrasound and hemorrhage into the atheroma demonstrated histopathologically have been shown to be associated with a higher risk of embolism. Twenty-nine consecutive patients with carotid artery stenosis and ...
Ishibashi A - - 1997
A 54-year-old female presented with acute subdural hematoma secondary to rupture of an intracranial aneurysm. She was admitted with acute onset of severe headache, nausea, and vomiting. There was no past history of head trauma. Computed tomography demonstrated a left subdural hematoma with extension along the tentorium in the absence ...
Macdonald R L - - 1997
A patient who had transcranial removal of a craniopharyngioma developed a large, postoperative subarachnoid hematoma in the basal cisterns. The patient developed cerebral vasospasm with infarction. A review of the literature found 20 cases of vasospasm associated with surgical removal of intracranial tumors. These cases were reviewed to determine the ...
Nakatomi H - - 1997
BACKGROUND AND PURPOSE: The clinical features of "aneurysmal" subarachnoid hemorrhage (SAH) of angiographically unverified etiology were reviewed to clarify the incidence and natural history of dissecting aneurysms as the hemorrhagic source of SAH. METHODS: We reviewed 30 patients with SAH of unverified etiology in whom initial CT scan showed a ...
Nakamura K - - 1997
A fifty-five-year-old woman with a history of migraine suddenly developed an occipital headache and visual disturbance after a typical migrainous attack. On admission, she had a left homonymous hemianopsia, and computed tomography of the brain demonstrated intracranial hematomas in the occipital subcortices bilaterally. Cerebral arteriography revealed diffuse vasospasm of the ...
Yamakawa H - - 1997
The clinical features of recurrent subarachnoid hemorrhage (SAH) after neck clipping surgery were investigated in a series of 1,436 consecutive patients treated between 1980 and 1994, and seven patients treated prior to 1980. Recurrent SAH occurred within 1 month in seven patients and between 1.5 and 20 years in 20 ...
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