A series of patients with subpial hemorrhage: Clinical manifestation, neuroradiological presentation and therapeutic implications

Roth, Patrick; Happold, Caroline; Eisele, Günter; Nägele, Thomas; Luft, Andreas R.

doi:10.1007/s00415-008-0824-8

Cited by 18 publications

(11 citation statements)

References 15 publications

(15 reference statements)

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“…Subpial hematomas are a rare type of intracerebral hemorrhage with an unclear mechanism and poor prognosis. [1][2][3][4] Previously Sylvian hematoma in subarachnoid hemorrhage (SAH) has been attributed to aneurysm rupture. 4 Recent case reports using 4D CT angiography (4D CTA) 5 6 suggest an additional mechanism for the development of Sylvian hematomas in patients with acute post-aneurysmal SAH that is separate from aneurysmal rebleeding.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4] Previously Sylvian hematoma in subarachnoid hemorrhage (SAH) has been attributed to aneurysm rupture. 4 Recent case reports using 4D CT angiography (4D CTA) 5 6 suggest an additional mechanism for the development of Sylvian hematomas in patients with acute post-aneurysmal SAH that is separate from aneurysmal rebleeding. We present a case of unilateral Sylvian hematoma secondary to multifocal bleeding points detected on conventional angiography during coiling of an acutely ruptured posterior communicating (PComm) artery aneurysm.…”

Section: Introductionmentioning

confidence: 99%

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Remote multifocal bleeding points producing a Sylvian subpial hematoma during endovascular coiling of an acutely ruptured cerebral aneurysm

2016

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Subpial hematoma is a rare type of intracranial hemorrhage with a poor prognosis. A new mechanism to explain subpial Sylvian hematoma formation in acute post-aneurysmal subarachnoid hemorrhage (SAH) was observed during coiling of a posterior communicating artery aneurysm. Multiple small bleeding points from pial branches of the left middle cerebral artery, which were remote from the ruptured aneurysm, were observed on conventional angiography. This bleeding led to the formation of a large expanding subpial Sylvian hematoma. Similar observations have been recently demonstrated on 4D CT angiography (4D CTA). We present a case that adds evidence to the literature in support of a new mechanism of subpial hematoma formation in the setting of acute SAH. This may advocate the early use of 4D CTA and conveys a poor prognosis, which might influence treatment decisions.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Remote multifocal bleeding points producing a Sylvian subpial hematoma during endovascular coiling of an acutely ruptured cerebral aneurysm

2016

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“…Reference to subpial hemorrhage has been made in the setting of perinatal hemorrhage, with pathology specimens demonstrating small clefts between the superficial glial processes and the pia mater and an absence of intraparenchymal hemorrhage and SAH at pathologic examination (41). Therefore, the results of CSF sampling did not show xanthochromia in 10 adult patients with subpial hemorrhage, as opposed to the results of CSF sampling in patients with SAH (42).…”

Section: Subpial Hemorrhagementioning

confidence: 99%

Pediatric Central Nervous System Imaging of Nonaccidental Trauma: Beyond Subdural Hematomas

et al. 2019

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Infants and children under 2 years of age are at greatest risk for devastating neurologic complications following nonaccidental trauma. While a subdural hematoma (SDH) is the most common finding and is often enough to raise suspicion for abuse, no single injury is pathognomonic for abusive head trauma (AHT). Rather, the combination of imaging and physical findings and the clinical presentation help confirm the diagnosis of AHT. Familiarity with the spectrum of findings and proper identification of the imaging abnormalities is important for the radiologist to facilitate treatment and removal of the patient from the abusive environment. Injury is usually a result of shaking, which includes hyperflexion, hyperextension, and rotational forces, and less commonly impact trauma or a combination of both. Key anatomic features unique to the infant's head, neck, and spine and associated biomechanical forces are responsible for entities such as hypoxic ischemic injury, bridging vein thrombosis, SDH, parenchymal lacerations, and spinal and retinal injuries. Although the association of subpial hemorrhage with AHT has not been investigated, it warrants attention in very young infants who endure accidental or inflicted trauma. A combination of CT of the head and MRI of the brain and cervical spine aids in the accurate diagnosis, appropriate management, and subsequent protection of these patients. ©

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“…Few cases of subpial haemorrhage have been described in the literature due to their relative rarity, which is estimated at approximately 4% according to pathological reports. 4 , 5 , 6 , 7 Consequently, there is a relative paucity of knowledge regarding its aetiology, associated clinical manifestations and outcomes. The risk factors and pathophysiology of this entity are unique compared with other forms of extra-axial haemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Factor XIII deficiency in a neonate presenting as subpial haemorrhage

Karthikeyan

Ronda

Sugumaran

2022

South African Journal of Radiology

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Subpial haemorrhage is a rare cause of seizures in term neonates. A 3-day-old male infant, born at term with no history of perinatal hypoxia, presented with seizures and unremarkable physical examination in the interictal state. Imaging demonstrated left temporal subpial haemorrhage with the classic ‘yin-yang sign’ on MRI. The patient was subsequently diagnosed with factor XIII deficiency. Follow-up at 6 months and 12 months revealed encephalomalacia in the previous haemorrhagic areas with normal developmental milestones.

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A series of patients with subpial hemorrhage: Clinical manifestation, neuroradiological presentation and therapeutic implications

Cited by 18 publications

References 15 publications

Remote multifocal bleeding points producing a Sylvian subpial hematoma during endovascular coiling of an acutely ruptured cerebral aneurysm

Remote multifocal bleeding points producing a Sylvian subpial hematoma during endovascular coiling of an acutely ruptured cerebral aneurysm

Pediatric Central Nervous System Imaging of Nonaccidental Trauma: Beyond Subdural Hematomas

Factor XIII deficiency in a neonate presenting as subpial haemorrhage

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