Cerebral aneurysm exclusion by CT angiography based on subarachnoid hemorrhage pattern: a retrospective study

<p>Abstract</p> <p>Background</p> <p>To identify patients with spontaneous subarachnoid hemorrhage for whom CT angiography alone can exclude ruptured aneurysms.</p> <p>Methods</p> <p>An observational retrospective review was carried out of all consecutive patients with non-traumatic subarachnoid hemorrhage who underwent both CT angiography and catheter angiography to exclude an aneurysm. CT angiography negative cases (no aneurysm) were classified according to their CT hemorrhage pattern as "aneurismal", "perimesencephalic" or as "no-hemorrhage."</p> <p>Results</p> <p>Two hundred and forty-one patients were included. A CT angiography aneurysm detection sensitivity and specificity of 96.4% and 96.0% were observed. All 35 cases of perimesencephalic or no-hemorrhage out of 78 CT angiography negatives also had negative angiography findings.</p> <p>Conclusions</p> <p>CT angiography is self-reliant to exclude ruptured aneurysms when either a perimesencephalic hemorrhage or no-hemorrhage pattern is identified on the CT within a week of symptom onset.</p

Meningioma cleavage - Response

WOS: 000087813100040

Evolution of Thrombosis of the Vein of Galen in Sickle Cell Disease

PubMedID: 8505485[No abstract available

Intracranial tuberculous abscess mimicking malignant glioma

PubMedID: 7753423Brain abscess is probably the least common manifestation of tuberculous infection of the central nervous system; meningitis and tuberculoma are much more common. A case of tuberculous brain abscess in a 23-year-old man with previous history of Tbc meningitis is presented. The computerized tomographic scan demonstrated a unilocular space-occupying lesion in the left thalamic region, surrounded by a thick hyperdense enhancing rim. It is suggested that a relatively long clinical history and previous Tbc meningitis history together with the appearance of a thick-walled abscesslike lesion on the CT scan may indicate the diagnosis of a tuberculous brain abscess. Only after neurosurgical removal of the abscess, the pathohistological examination reveal tuberculous etiology of the abscess. The patient later died from aspiration bronchopneumonia. Only 28 instances of tuberculous abscess have been reported in the literature. © 1994 Walter de Gruyter & Co

Prognosis and prognostic factors in nonaneurysmal perimesencephalic hemorrhage a follow-up study in 29 patients

WOS: 000175779500008PubMed ID: 12009538BACKGROUND Perimesencephalic nonaneurysmal hemorrhage is a benign form of subarachnoid hemorrhage with a low risk of rebleeding. The authors conducted a retrospective study to investigate the prognosis, possible prognostic factors, and long-term natural history in perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSH). METHODS This report contains a retrospective analysis of 29 patients with PNSH who were followed from I month to 8 years with an average follow-up period of 5.4 years. We evaluated computed tomography (CT) scan features; clinical grade; loss of consciousness during hemorrhage; ventricular ratio; angiographic spasm; complications such as ischemic complications, early rebleeding, late rebleeding, epilepsy, hydrocephalus, and fixed ischemic deficit; and outcome. RESULTS There were 7 men and 22 women, and the ages ranged from 22 to 69 years (mean 49.5 years). In the group with PNSH 93% of the patients were in grade I-II, as compared to 70.8% of patients with non-PNSH according to the Hunt and Hess system. Loss of consciousness during hemorrhage was detected in 9 patients (31%). We observed acute hydrocephalus in 4 patients (13.7%). The first cerebral four-vessel angiograms disclosed vasospasm in 3 patients (10.3%). Patients with PNSH have the best outcome according to the activities of daily living (ADL) grading system when compared with other groups of patients with negative angiogram (aneurysmal pattern and invisible blood). CONCLUSION This study provides evidence that patients with PNSH have an uncomplicated course and a particularly favorable outcome. (C) 2002 by Elsevier Science Inc

EVOLUTION OF THROMBOSIS OF THE VEIN OF GALEN IN SICKLE-CELL DISEASE

WOS: A1993LB79000017PubMed ID: 8505485

Cervical intradural extramedullary hydatid cyst

A case of intradural extramedullary hydatid cyst with spinal cord compression located in the cervical region is presented. The diagnosis was made preoperatively on the basis of MRI findings. Many cases of cranial or spinal extradural hydatid cyst have been reported in the literature, but intradural extramedullar location of the cyst in the cervical region is extremely rare