The source of haemorrhage in traumatic basal subarachnoid haemorrhage

Wong, Brittany; Ong, Boon Hoong; Milne, Nathan

doi:10.1016/j.jflm.2014.09.012

Cited by 17 publications

(5 citation statements)

References 22 publications

(72 reference statements)

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“…However, Leadbeatter suggested that extracranial vertebral artery injury could be a concomitant lesion and that the bleeding focus might be an unidentified vascular tear inside the cranial cavity [7]. Currently, many pathologists believe that the more common site of rupture in TBSAH is the intracranial vertebral artery [2,8].…”

Section: Discussionmentioning

confidence: 99%

“…TBSAH can be fatal, as it can lead to instantaneous loss of consciousness and death. The most common site of vascular rupture is thought to be the vertebral artery, particularly the intracranial course [1,2]. However, because of the position of the vertebral artery in the cranial cavity, it is difficult to determine the bleeding focus on routine autopsy; also, the intracranial vertebral arteries are normally cut to remove the brain.…”

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confidence: 99%

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Inconspicuous longitudinal tears of the intracranial vertebral artery in traumatic basal subarachnoid hemorrhage

Kim¹

2020

J Pathol Transl Med

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Blunt force trauma to the head or neck region can cause traumatic basal subarachnoid hemorrhage (TBSAH), which can result in rapid loss of consciousness and death; however, detecting such a vascular injury is difficult. Posterior neck dissection was performed to investigate the bleeding focus in TBSAH cases 2018 and 2019. In all four cases, autopsies revealed a longitudinal tear in the midsection of the vertebral artery's intracranial portion. The midportion of the intracranial vertebral artery appears to be most vulnerable to TBSAH. Interestingly, three of the cases showed only a vaguely visible longitudinal fissure in the artery without a grossly apparent tear; rupture was confirmed by microscopic examination. Longitudinal fissures of the intracranial vertebral artery, which are difficult to identify without detailed examination, may be overlooked in some cases of TBSAH. Thus, careful gross and microscopic examination of the vertebral artery is recommended in cases of TBSAH.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Inconspicuous longitudinal tears of the intracranial vertebral artery in traumatic basal subarachnoid hemorrhage

Kim¹

2020

J Pathol Transl Med

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“…4 Most common form of the vascular injury is from the intracranial portion of vertebral artery. 5 Possible mechanisms described in the literature for traumatic SAH are (1) direct trauma to vessel, (2) extensive stretching during hyperextension or rotation of the neck, (3) oscillation of brain with shearing forces, (4) increased intravascular pressure from severe blow to cervical internal carotid artery (ICA), (5) tearing of the vein or pial vessels, and (6) dissemination of blood from hemorrhagic contusion into subarachnoid space, and (7) no cause or idiopathic. Basal SAH can be confused with aneurismal bleed and hence needs to be evaluated.…”

Section: Discussionmentioning

confidence: 99%

Posttraumatic Isolated Diffuse SAH Because of Atlas (C1) Fracture Involving Transverse Process without Vertebral Artery Injury: A Case Report

Patil,

Iratwar,

Jha

2024

Indian Journal of Neurosurgery

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Traumatic subarachnoid hemorrhage (SAH) can be seen in mild, moderate, and severe head injury. Traumatic SAH is usually present in the sulci or superficial subarachnoid space (SAS) of the cortex rather than in the basal SAS. Basal SAH is usually harmful because of the injury to vascular structure resulting into vasospasm and ischemia. Here we are presenting a rare case in which patient is presented with traumatic injury to the neck followed by the isolated diffuse SAH mostly basal without injury to the brain parenchyma. Patient was presented with the raised intracranial pressure features (headache, vomiting) and seizure. On admission, he had a Glasgow Coma Scale of E3V3M5. His computed tomography (CT) of the brain was suggestive of diffuse SAH in all cisterns especially in basal cistern. He was evaluated by angiogram that was suggestive of no major vascular involvement. His CT cervical spine was suggestive of Atlas (C1) fracture involving transverse process with medial and inward displacement of bone, probably causing vascular insult in the form of venous injury leading to the SAH.

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“…To achieve this, an additional post-mortem radiological imaging examination can currently be performed, preferably with a contrast medium, e.g. post-mortem angio-CT [4,13].…”

Section: Discussionmentioning

confidence: 99%

“…Obecnie w tym celu można dodatkowo wykorzystać pośmiertne badanie obrazowe radiologiczne, optymalnie z podaniem środka cieniującego, np. podczas pośmiertnego badania angio-TK [4,13]. the airways, which was recognized as another factor contributing to the mechanism of death.…”

Section: Omówienieunclassified

Traumatic basal subarachnoid haemorrhage or ruptured brain aneurysm in 16-year-old boy? – case report

Skowronek

Kobek

Jankowski

et al. 2016

amsik

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The source of haemorrhage in traumatic basal subarachnoid haemorrhage

Cited by 17 publications

References 22 publications

Inconspicuous longitudinal tears of the intracranial vertebral artery in traumatic basal subarachnoid hemorrhage

Inconspicuous longitudinal tears of the intracranial vertebral artery in traumatic basal subarachnoid hemorrhage

Posttraumatic Isolated Diffuse SAH Because of Atlas (C1) Fracture Involving Transverse Process without Vertebral Artery Injury: A Case Report

Traumatic basal subarachnoid haemorrhage or ruptured brain aneurysm in 16-year-old boy? – case report

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