Bleeding of Perivascular Spaces in Midbrain of a Young Patient With Head Trauma

Galli, Federica; Pandolfi, Marco; Liguori, Alessandro; Gurgitano, Martina; Sberna, Maurizio

doi:10.7759/cureus.12884

Cited by 4 publications

(1 citation statement)

References 10 publications

(13 reference statements)

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“…After exclusion of aneurysmal pathology, the cause of the bleeding usually remains unknown as there are a lot of possible incriminating factors as well as other possible diagnoses that should not be overlooked including dural venous sinus thrombosis, cerebral vascular malformation or trauma [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Non-Aneurysmal Perimesencephalic Subarachnoid Hemorrhage: A Literature Review

et al. 2023

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Spontaneous non-aneurysmal subarachnoid haemorrhage (NAPMSAH) (addressing point 1) is a relatively rare occurrence in clinical settings as it is rarely misdiagnosed and usually involves a significantly better prognosis than the classical aneurysmal pattern. We hereby focused on a comprehensive analysis of this distinct pathological entity with the purpose of analysing possible pathophysiological entities, outcomes and treatment options involving this diagnosis with a focus on demographical, epidemiological and clinical data. The clinical setting includes focal neurological signs related to the anatomical structures, while computer tomography followed by tomographic angiography are the most common diagnosis tools, with a typical hyperdense lesion involving the midbrain, fourth ventricle and subthalamic areas without an angiographic correspondent, such as an aneurysmal pathology. Further investigations can also be used to highlight this diagnosis, such as interventional angiography or magnetic resonance imaging. Given the rarity of this condition and its relatively better prognosis, treatment options usually remain conservative. In the present review, the main characteristics of NAPMSAH are discussed.

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Section: Introductionmentioning

confidence: 99%

Non-Aneurysmal Perimesencephalic Subarachnoid Hemorrhage: A Literature Review

et al. 2023

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Post-traumatic bleeding in a giant perivascular space

Fonseca

Guarnizo

2023

Neurol Sci

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Enlarging and shrinking focal perivascular spaces

Boutet,

Son,

Malik

et al. 2024

Neuroradiol J

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Background and Purpose Perivascular spaces (PVS) are interstitial fluid-filled spaces surrounding blood vessels traversing the deep gray nuclei and white matter of the brain. These are commonly encountered on CT and MR imaging and are generally asymptomatic and of no clinical significance. However, occasional changes in the size of focal PVS, for example, when enlarging, may mimic pathologies including neoplasms and infections, hence potentially confounding radiological interpretation. Given these potential diagnostic issues, we sought to better characterize common clinical and imaging features of focal PVS demonstrating size fluctuations. Materials and Methods Upon institutional approval, we retrospectively identified 4 cases demonstrating PVS with size changes at our institution. To supplement our cases, we also performed a literature review, which identified an additional 14 cases. Their clinical and imaging data were analyzed to identify characteristic features. Results Of the 18 total cases (including the 4 institutional cases), 10 cases increased and 8 decreased in size. These focal PVS ranged from 0.4–4.5 cm in size. Whereas a decrease in size did not represent a diagnostic issue, focal increase in size of PVS led to concerning differential diagnoses in at least 30% of the radiology reports. These enlarging PVS were most found in the basal ganglia and temporal lobe, and in patients with previous brain radiation treatment. Conclusion Focal size change of PVS can occur, especially years after brain radiation treatment. Being cognizant of this benign finding is important to consider in the differential diagnosis to avoid undue patient anxiety or unnecessary medical intervention.

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Bleeding of Perivascular Spaces in Midbrain of a Young Patient With Head Trauma

Cited by 4 publications

References 10 publications

Non-Aneurysmal Perimesencephalic Subarachnoid Hemorrhage: A Literature Review

Non-Aneurysmal Perimesencephalic Subarachnoid Hemorrhage: A Literature Review

Post-traumatic bleeding in a giant perivascular space

Enlarging and shrinking focal perivascular spaces

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