Document Detail

Early ischemic lesions following subarachnoid hemorrhage: common cold remedy as precipitating factor?
MedLine Citation:
PMID:  21510236     Owner:  NLM     Status:  In-Process    
A 46-year-old woman presented with tetraplegia contrasting with a relatively preserved consciousness following aneurysmal subarachnoid hemorrhage (SAH). Multiple ischemic lesions were detected by magnetic resonance imaging (MRI), in the absence of vasospasm or signs of increased intracranial pressure. During the weeks before SAH, the patient had repeatedly used a nasal decongestant containing phenylephrine. After coiling of the aneurysm harboured by the right posterior cerebral artery, symptomatic vasospasm developed in the territory of the right middle cerebral artery and required aggressive therapy by intra-arterial infusion of milrinone followed by continuous intravenous administration. Follow-up MRI did not reveal new ischemic lesions. Echocardiography had demonstrated the presence of a patent foramen ovale. At 3 months follow-up, a major motor deficit persisted with akinetic mutism. The mechanisms of multiple early infarction following aneurysmal SAH are still debated, as vasospasm is usually not seen on the first imaging. Among precipitating factors of microvascular vasospasm, vasoactive substances like phenylephrine, may play a significant role.
Sandrine Genonceaux; Guy Cosnard; Françoise Van De Wyngaert; Philippe Hantson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta neurologica Belgica     Volume:  111     ISSN:  0300-9009     ISO Abbreviation:  Acta Neurol Belg     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-04-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0247035     Medline TA:  Acta Neurol Belg     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  59-61     Citation Subset:  IM    
Department of Intensive Care, Université catholique de Louvain, Brussels, Belgium.
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