Subarachnoid hemorrhage is uncommon in pregnancy and may be caused by intracranial aneurysms, arteriovenous malformations, venous thrombosis, or preeclampsia. We present an unusual case of subarachnoid hemorrhage in a term parturient where the bleeding originated from an extracranial source, namely a cervicothoracic arteriovenous malformation. This case highlights the challenge of diagnosing this condition when the initial presentation may be nonspecific, lacking in neurologic deficits, and confounded by the simultaneous presence of preeclampsia.
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http://dx.doi.org/10.1213/XAA.0000000000001521 | DOI Listing |
Neurosurg Rev
January 2025
Kobayashi Hospital, 510 Imaichi, Izumo City, Shimane, 693-0001, Japan.
Adverse effects of advanced age and poor initial neurological status on outcomes of patients with aneurysmal subarachnoid hemorrhage (SAH) have been documented. While a predictive model of the non-linear correlation between advanced age and clinical outcome has been reported, no previous model has been validated. Therefore, we created a prediction model of the non-linear correlation between advanced age and clinical outcome by machine learning and validated it using a separate cohort.
View Article and Find Full Text PDFJ Neuroimaging
January 2025
Department of Neurology, Georgetown University School of Medicine, Washington, District of Columbia, USA.
Background And Purpose: While the pulsatility index (PI) measured by transcranial Doppler (TCD) has broader associations with outcomes in neurocritical care, its use in monitoring delayed cerebral infarction (DCI) in patients with aneurysmal subarachnoid hemorrhage (SAH) is not endorsed by current clinical guidelines. Recognizing that arterial pressure gradient (ΔP) can be estimated using PI, we investigated the potential significance of TCD-estimated ΔP.
Methods: In this observational study of 186 SAH patients, we recorded the mean cerebral blood flow velocity (mCBFV) and PI values from the middle cerebral artery, along with corresponding blood pressures.
Korean J Neurotrauma
December 2024
Department of Neurosurgery, Fundación Universitaria de Ciencias de la Salud (FUCS), Hospital de San José - Sociedad de Cirugía de Bogotá, Bogotá, Colombia.
Objective: The goal of a decompressive craniectomy (DC) or a hinge craniotomy (HC), is to treat intracranial hypertension and reduce mortality. Traditionally, the decompression procedure has been performed with cranial bone removal. However, decompression and repositioning the cranial bone, named HC, has been presented as an alternative for certain cases.
View Article and Find Full Text PDFCureus
December 2024
Neurosurgery, Hospital de Braga, Braga, PRT.
Introduction A large majority of spontaneous subarachnoid hemorrhages (SAH) are attributed to aneurysm rupture, though the cause remains unknown in a notable percentage of cases. Non-aneurysmal SAH (naSAH) is generally thought to follow a more benign clinical course than aneurysmal SAH (aSAH); however, similar complications may occur, and poor outcomes are still possible. Given the limited research on naSAH, this study aims to characterize these patients and correlate clinical and radiographic findings with outcomes.
View Article and Find Full Text PDFBrain Spine
December 2024
Department of Neurosurgery, Hospital de Braga, R. das Sete Fontes, 4710-243, Braga, Portugal.
Introduction: Aneurysmatic subarachnoid hemorrhages (aSAH) are life-threatening events with high mortality and morbidity. Hydrocephalus is a common complication, initially managed with an external ventricular drain (EVD). Persistent hydrocephalus often requires ventriculoperitoneal shunt (VPS) placement to relieve intracranial pressure and prevent further neurological damage.
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