Document Detail

Clinical problem-solving: aneurysm or spinal arteriovenous fistula-bait and switch.
MedLine Citation:
PMID:  21311283     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The authors use an instructive case to review the challenges of diagnosis in subarachnoid hemorrhage (SAH) and to reinforce the nuances of clinical management.
IMPORTANCE: The presented case highlights critical issues in patient selection and challenges in the diagnosis of SAH and the management of both aneurysmal and arteriovenous fistula-related SAH. The critical points in decision making and diagnosis are discussed, and the case is accompanied by a brief review of the literature on the issues being faced.
CLINICAL PRESENTATION: The present case is a patient presenting with SAH who was found to have an anterior communicating artery aneurysm. However, clues in the presentation and workup point to another etiology.
CONCLUSION: A strong history of sudden neck pain before headache and abundance of SAH along the brainstem mandates a need to thoroughly evaluate the source of hemorrhage from cervical vessels through an angiogram.
Jeffrey F Lastfogel; Bernard R Bendok; Nicholas M Boulis; Aaron A Cohen-Gadol
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  68     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-11     Completed Date:  2011-06-17     Revised Date:  2011-09-20    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E866-73     Citation Subset:  IM    
Goodman Campbell Brain and Spine, and Indiana University Department of Neurological Surgery, Indianapolis, Indiana 46202, USA.
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MeSH Terms
Central Nervous System Vascular Malformations / diagnosis*,  surgery*
Diagnosis, Differential
Middle Aged
Spinal Cord / abnormalities*,  blood supply,  surgery*
Subarachnoid Hemorrhage / diagnosis*,  surgery*
Treatment Outcome
Comment In:
Neurosurgery. 2011 Sep;69(3):E787-8; author reply E788   [PMID:  21623243 ]

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

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