Document Detail

Paraparesis associated with ruptured anterior cerebral artery territory aneurysms.
MedLine Citation:
PMID:  16051005     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Paraparesis is a rare but characteristic manifestation of ruptured anterior communicating artery or anterior cerebral artery (ACA) aneurysms, but the pathogenesis remains unclear. This study investigated the neuroimaging and clinical features of patients with such paraparesis to evaluate possible causes. METHODS: Nine of 178 patients with ruptured anterior communicating artery or ACA aneurysms presented with paraparesis among 462 patients with subarachnoid hemorrhage (SAH) admitted between May 1996 and November 2001. Diffusion-weighted magnetic resonance (MR) imaging was performed within 48 hours of the onset of SAH in 4 of these 9 patients. The clinical course and neuroimaging studies of these 4 patients were retrospectively reviewed. RESULTS: Diffusion-weighted MR imaging revealed -intensity areas in the medial aspects of the bilateral frontal lobes, which were supplied by the ACAs and distal to the aneurysms, in all 4 patients. These high-intensity lesions had normal to subnormal values of apparent diffusion coefficient (ADC). Most of the high-intensity lesions recovered and did not result in the final lesions regardless of the ADC values, but some lesions with subnormal ADC values resulted in cerebral infarction. Paraparesis was transient and almost completely resolved in 3 patients. CONCLUSIONS: Diffusion-weighted MR imaging detected primary brain damage in the ACA territories caused by acute SAH, which was compatible with the clinical paraparesis. Primary brain damage caused by SAH may include 3 types of lesions: reversible with normal ADC value, reversible with subnormal ADC value, and irreversible with subnormal ADC value.
Hidenori Endo; Hiroaki Shimizu; Teiji Tominaga
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  64     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-07-29     Completed Date:  2005-08-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  135-9; discussion 139     Citation Subset:  IM    
Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan.
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MeSH Terms
Aneurysm, Ruptured / complications*,  pathology*
Brain / blood supply,  pathology
Diffusion Magnetic Resonance Imaging
Intracranial Aneurysm / complications*,  pathology*
Middle Aged
Paraparesis / etiology*
Subarachnoid Hemorrhage / etiology

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