Document Detail


Ultra-Early Aneurysmal Rebleeding and Brainstem Destruction.
MedLine Citation:
PMID:  22045249     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Early secondary neurologic deterioration after aneurysmal subarachnoid hemorrhage (SAH) may have many causes including rebleeding, hydrocephalus, parenchymal hematoma, or seizures. METHODS: Case report. RESULTS: A 69-year-old woman presented with thunderclap headache and nausea. A head computed tomography (CT) showed SAH. On initial evaluation she was awake, alert, and confused without focal neurologic deficits. Two episodes of marked clinical deterioration occurred, manifesting as acute unresponsiveness and fixed anisocoria. Serial head CTs showed massive extension of hemorrhage into the brainstem parenchyma and ventricles. CONCLUSIONS: Sudden clinical deterioration after SAH with coma and a fixed "blown" pupil may result from hemorrhage extension into the brainstem parenchyma rather than oculomotor nerve injury from compression or stretch.
Authors:
Jennifer E Fugate; Grant W Mallory; Eelco F M Wijdicks
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-2
Journal Detail:
Title:  Neurocritical care     Volume:  -     ISSN:  1556-0961     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Critical Care Neurology, Mayo Clinic, Rochester, MN, 55905, USA, fugate.jennifer@mayo.edu.
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