Document Detail


Acute lacunar stroke in association with angiogram-negative subarachnoid hemorrhage. Mechanistic implications of two cases.
MedLine Citation:
PMID:  7740585     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Although there is much speculation regarding the source of bleeding in patients with subarachnoid hemorrhage when no angiographic abnormality is found, little direct evidence has been obtained to document a cause. We report two cases of stroke in the distribution of a perforating or lenticulostriate artery occurring at the time of angiogram-negative subarachnoid hemorrhage. CASE DESCRIPTIONS: A 68- and a 60-year-old man each presented with acute onset of headache and meningismus. Computed tomography (CT) revealed subarachnoid hemorrhage in a perimesencephalic pattern and in the left sylvian fissure, respectively. In both instances, immediate CT revealed evidence of an early infarction in the distribution of a perforating artery originating at the site of the subarachnoid blood. Both of these strokes were demonstrated to be acute by evolution on serial imaging studies. No source for the subarachnoid blood could be found in either patient in cerebral angiograms repeated at 2 weeks. CONCLUSIONS: These observations suggest that in some cases of angiogram-negative subarachnoid hemorrhage the source of blood may be a small artery that is obliterated at the time of hemorrhage. This observation provides an explanation for the low rate of rehemorrhage among patients with angiogram-negative subarachnoid hemorrhage.
Authors:
S B Tatter; F S Buonanno; C S Ogilvy
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  26     ISSN:  0039-2499     ISO Abbreviation:  Stroke     Publication Date:  1995 May 
Date Detail:
Created Date:  1995-06-06     Completed Date:  1995-06-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  891-5     Citation Subset:  IM    
Affiliation:
Neurosurgical Service, Massachusetts General Hospital, Boston 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Brain / radiography
Cerebral Angiography*
Cerebrovascular Disorders / complications*,  radiography
False Negative Reactions
Humans
Male
Middle Aged
Subarachnoid Hemorrhage / complications,  radiography*
Time Factors
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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