tailieunhanh - báo cáo khoa học: "Benign perimesencephalic hemorrhage occurring after previous aneurysmal subarachnoid hemorrhage: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Benign perimesencephalic hemorrhage occurring after previous aneurysmal subarachnoid hemorrhage: a case report | Singleton et al. Journal of Medical Case Reports 2010 4 405 http content 4 1 405 WV journalof medical l rCASE REPORTS CASE REPORT Open Access Benign perimesencephalic hemorrhage occurring after previous aneurysmal subarachnoid hemorrhage a case report Richard H Singleton Dean B Kostov Hilal A Kanaan Michael B Horowitz Abstract Introduction Both aneurysmal subarachnoid hemorrhage and benign perimesencephalic hemorrhage are well-described causes of spontaneous subarachnoid hemorrhage that arise as a result of different pathologic processes. To the best of the authors knowledge there have been no reports of both vascular pathologies occurring in the same individual. Case presentation A 51-year-old Caucasian woman with a history of aneurysmal subarachnoid hemorrhage presented five years after her initial treatment with ictal headache meningismus nausea and emesis similar to her previous bleeding event. Computed tomographic imaging revealed perimesencephalic bleeding remote from her previously coiled anterior communicating artery aneurysm. Both immediate and delayed diagnostic angiography revealed no residual filling of the previously coiled aneurysm and no other vascular anomalies consistent with benign perimesencephalic hemorrhage. The patient had an uneventful hospital course and was discharged to home in good condition. Conclusions This report for the first time identifies benign perimesencephalic hemorrhage occurring in the setting of previous aneurysmal subarachnoid hemorrhage. The presence of a previously treated aneurysm can complicate the process of diagnosing benign perimesencephalic hemorrhage. Fortunately in this case the previously treated anterior communicating artery aneurysm was remote from the perimesencephalic hemorrhage and could be ruled out as a source. The patient s prior aneurysmal subarachnoid hemorrhage did not worsen the anticipated good outcome associated with benign perimesencephalic hemorrhage. Introduction .