Cerebral CT Perfusion in Patients with Perimesencephalic and Those with Aneurysmal Subarachnoid Hemorrhage

Cremers, Charlotte H. P.; Schaaf, Irene C. van der; Dankbaar, Jan Willem; Velthuis, Birgitta K.; Rinkel, Gabriël J.E.

doi:10.1111/ijs.12021

Cited by 8 publications

(4 citation statements)

References 29 publications

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“…In PNSAH, oxyhemoglobin from the vein, which is at a low concentration, cannot trigger stress and immune-mediated inflammatory responses ( 40 , 41 ). Severely increased intracranial pressure is rare at the onset of PNSAH due to the low incidence of low-pressure venous hemorrhage, which indicates that patients with PNSAH have good cerebral perfusion ( 42 ). Fragata et al's ( 43 ) study of CT perfusion showed that patients with PNSAH had better cerebral perfusion than aneurysmal SAH patients in the first 72 h.…”

Section: Definition and Variantmentioning

confidence: 99%

Current status of perimesencephalic non-aneurysmal subarachnoid hemorrhage

Hou

2022

Front. Neurol.

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Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) is a distinctive disease, representing SAH centered in perimesencephalic cisterns, with negative angiography findings. In recent years, the number of patients with PNSAH has increased significantly; however, the knowledge of PNSAH is insufficient. Therefore, we performed a review of the literature from a PubMed search and recounted our understanding of PNSAH. In this review, we summarized that current high-resolution computed tomography angiography is an acceptable replacement for digital subtraction angiography to rule out aneurysms in PNSAH with strict criteria. The current hypothesis about the etiology of PNSAH is that there is deep vein rupture from aberrant venous anatomy and increased intracranial venous pressure. PNSAH is associated with mild symptoms and lower rates of hydrocephalus and symptomatic vasospasm. For PNSAH, conservative treatment has been the mainstream treatment. PNSAH has a benign clinical course and an excellent prognosis; in long-term follow-up, re-bleeding and death were uncommon.

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Section: Definition and Variantmentioning

confidence: 99%

Current status of perimesencephalic non-aneurysmal subarachnoid hemorrhage

Hou

2022

Front. Neurol.

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“…We found only one study in the literature that compared CTP perfusion in PMH and aneurysmal SAH on the first 72 h after ictus [11]. In that study, which included 45 patients with PMH and 45 with aSAH, Cremers and colleagues showed that PMH patients have higher CBF than aSAH patients.…”

Section: Discussionmentioning

confidence: 99%

“…It is known that vasospasm is less frequent in PMH patients, and if it occurs, it has less clinical impact [10]. Previous research based on CT perfusion (CTP) suggested that cerebral blood flow (CBF) is higher in PMH patients compared to aSAH in the first 72 h after SAH [11]. However, differences in cerebral perfusion during the vasospasm time window have not been evaluated in PMH patients.…”

Section: Introductionmentioning

confidence: 99%

Comparison of cerebral perfusion in perimesencephalic subarachnoid hemorrhage and aneurysmal subarachnoid hemorrhage

2018

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“…The most common assumption is that PMH has a venous instead of an arterial origin. Apart from the invariably good clinical condition on admission and the limited extension of the hemorrhage, other arguments for a venous source are the higher presence of a primitive variant of venous drainage compared with controls and a higher cerebral blood flow on admission head CT perfusion in patients with PMH compared with patients with aSAH .…”

Section: Discussionmentioning

confidence: 99%