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Acute Spinal Epidural Hematoma and Cranial Interdural Hematoma Due to a Rupture of a Posterior Communicating Artery Aneurysm.
MedLine Citation:
PMID:  21577169     Owner:  NLM     Status:  Publisher    
BACKGROUND AND IMPORTANCE:: We describe an unusual presentation of a ruptured aneurysm of the posterior communicating artery with an acute intracranial hematoma in between the dural layers associated with an acute spinal epidural hematoma descending to L1. CLINICAL PRESENTATION:: 35-year old woman, presenting 3 hours after ictus with a post-coital headache, neck stiffness and bilateral abducens cranial nerve palsy. No other neurological deficit. Clinically SAH WFNS 1. CT scan demonstrates an acute subdural hematoma, extending from the right parasellar region, around the clivus, tentorium and falx. Angio-CT showed a posterior communicating artery aneurysm and an anterior communicating artery aneurysm and an extension of the hematoma to the cervical spine. This justified a spinal and cerebral MRI that confirmed an extension of the hematoma to the epidural space at the cervical, thoracic and lumbar levels. 3D DSA confirmed aneurysms on the right posterior communicating artery and on the anterior communicating artery. Both aneurysms were completely occluded by coiling. With reference to the concept of the cranial subdural compartment described in studies conducted using an electron microscope, this group of hematomas was classified as interdural. CONCLUSION:: Ruptured aneurysm of the posterior communicating artery may cause cranial acute interdural hematoma with a typical SAH clinical presentation and it rarely can extend to spinal epidural space.
Andrea Bartoli M D; Marc Kotowski M D; Vitor Mendes Pereira; Karl Schaller M D
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-13
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Departement of Neurosurgery, Geneva University Hospital, Switzerland; 2Departement of Neuroradiology, Geneva University Hospital, Switzerland.
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