Nontraumatic Convexal Subarachnoid Hemorrhage Concomitant with Acute Ischemic Stroke

Nakajima, Makoto; Inatomi, Yuichiro; Yonehara, Toshiro; Hirano, Teruyuki; Ando, Yumiko

doi:10.1016/j.jstrokecerebrovasdis.2013.12.046

Cited by 24 publications

(31 citation statements)

References 17 publications

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“… 1 In a retrospective review of 4 953 patients with acute stroke/transient ischemic attack involving eight (0.16%) patients with cSAH, five patients had occlusion of major arteries and three were suggested as having cerebral amyloid angiopathy. 5 Several studies have suggested that cerebral amyloid angiopathy is a common cause of cSAH. 1 , 3 , 5 , 6 In the present study, nine patients had gradient recalled echo T2*-weighted MRIs and none fulfilled the criteria for possible or probable cerebral amyloid angiopathy (including multiple haemorrhages of varying sizes/ages with no other explanation, or a single lobar, cortical, or cortical/subcortical haemorrhage without another cause, multiple haemorrhages with a possible but not a definite cause, or some haemorrhage in an atypical location).…”

Section: Discussionmentioning

confidence: 99%

Incidence and possible causes of nontraumatic convexal subarachnoid haemorrhage in Chinese patients: A retrospective review

Zhao

Han

et al. 2016

J Int Med Res

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ObjectiveTo explore the incidence and possible underlying pathogenic mechanisms of nontraumatic convexal subarachnoid haemorrhage (cSAH; a rarely reported condition) in a cohort of Chinese patients.MethodsMedical records from all patients with subarachnoid haemorrhage (SAH) who had been treated at Peking University Third Hospital, China, between January 2010 and December 2014 were retrospectively reviewed to identify cases of cSAH.ResultsOf 144 patients with SAH, cSAH was observed in 14 cases (9.7%). The most frequent presenting symptoms in cSAH cases were severe headache (n = 8) and a focal neurological deficit (n = 8). The parietal (10/14 patients, 71.4%) and frontal (9/14 patients, 64.3%) lobes were the most common haemorrhage sites. Cause of cSAH was identified in 11 patients: in seven cases (50.0%), significant stenosis or occlusion in the internal carotid artery system, ipsilateral to cSAH, was reported; in four cases, cSAH was caused by cerebral venous sinus thrombosis, cerebrovascular malformation, anticoagulant therapy or possible cerebral amyloid angiopathy.ConclusioncSAH is an important subtype of nonaneurysmal SAH, with diverse aetiologies. In the present study, internal carotid artery system atherosclerotic stenosis was the most frequent cause of cSAH.

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Section: Discussionmentioning

confidence: 99%

Incidence and possible causes of nontraumatic convexal subarachnoid haemorrhage in Chinese patients: A retrospective review

Zhao

Han

et al. 2016

J Int Med Res

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“…Nakajima et al assumed that the accompanying an infarction and non traumatic CSAH might demonstrate that hemodynamic insufficiency because of arterial stenosis or occlusion get to the critical point. For instance, after an acute infarction due to occlusive disease by the embolic or hemodynamic mechanism, ensuing dynamic changes of intracranial perfusion pressure might bring about the CSAH 14). Also Cuvinciuc et al explained that the main mechanism of CSAH because of chronic arterial occlusive diseases is considered to be the rupture of dilated vulnerable compensatory pial vessels 3)…”

Section: Discussionmentioning

confidence: 99%

Evaluation and Treatment of the Acute Cerebral Infarction with Convexal Subarachnoid Hemorrhage

Lee

Kim

Lee

et al. 2016

J Cerebrovasc Endovasc Neurosurg

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Non-traumatic convexal subarachnoid hemorrhage (CSAH) is a comparatively infrequent with various vascular and nonvascular causes, it rarely occurs concomitant to acute ischemic stroke. We report a case of a 59-year-old woman, visited emergency room with right side subjective weakness spontaneously. Magnetic resonance diffusion-weighted images revealed an acute infarction of anterior cerebral arterial territory. Computed tomographic angiography showed a left frontal CSAH without any vascular lesions. And other laboratory studies were non-specific. We treated with dual antiplatelet drugs (cilostazole [Otsuka Pharmaceutical Co., Ltd. tokyo, Japan] and Aspirin [Bayer Pharma AG., Leverkusen, Germany]). She has done well for a follow-up period. (5 months) This case demonstrates the CSAH with acute infarction is rare but need to work up to identify the etiology and antiplatelet dugs are taken into account for treatments.

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“…However, in view of the small size of the ACA, it is not possible to observe these typical radiological findings in all patients with ACA dissection. It has been reported that intracranial artery dissection can present with aneurysmal dilatation, segmental stenosis or occlusion (19). It is worthy of note that fusiform or irregular aneurysmal dilation at a non-branching site is very suggestive of intracranial artery dissection if it is associated with a segmental stenosis.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the diagnosis of RCVS was excluded by those imaging features. In 2014, Nakajima et al (19) suggested a diagnosis of CAA in two patients presenting with SAH accompanied with AIS concomitantly. However, none of the patients with CAA showed stenosis and dilatation of the cerebral artery.…”

Section: Discussionmentioning

confidence: 99%

Good recovery of subarachnoid hemorrhage concomitant with ischemia due to anterior cerebral artery dissection by conservative treatment: A case report

Wang

Yang

Shi

et al. 2017

Experimental and Therapeutic Medicine

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The present report describes the case of a 57-year-old woman presenting with subarachnoid hemorrhage (SAH) and acute ischemic stroke (AIS) due to anterior cerebral artery (ACA) dissection, which exhibited severe stenosis at the origin with distal dilatation of the A2 segment and occlusion of the A3 segment. In this case, computed tomography (CT) revealed SAH in right superior frontal sulcus and the interhemispheric fissure. Magnetic resonance imaging demonstrated acute infarct in the territory of the right ACA. Brain digital subtraction angiography showed severe stenosis at the origin of the A2 segment with distal dilatation and occlusion at the origin of the A3 segment of the right ACA, suggesting a diagnosis of dissection. Only treatment with atorvastatin, her clinical condition subsequently improved. The stenosis and dilatation of A2 segment were ameliorated as demonstrated by a follow-up CT angiography 5 months after onset. SAH concomitant with ischemia caused by ACA dissection is rare. Conservative treatment may be a safe and effective choice for patients with SAH concomitant with AIS due to ACA dissection.

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Nontraumatic Convexal Subarachnoid Hemorrhage Concomitant with Acute Ischemic Stroke

Cited by 24 publications

References 17 publications

Incidence and possible causes of nontraumatic convexal subarachnoid haemorrhage in Chinese patients: A retrospective review

Incidence and possible causes of nontraumatic convexal subarachnoid haemorrhage in Chinese patients: A retrospective review

Evaluation and Treatment of the Acute Cerebral Infarction with Convexal Subarachnoid Hemorrhage

Good recovery of subarachnoid hemorrhage concomitant with ischemia due to anterior cerebral artery dissection by conservative treatment: A case report

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