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Intracranial Extension of Spinal Subarachnoid Hematoma Causing Severe Cerebral Vasospasm

Spinal subarachnoid hemorrhages (SAH) can extend into the intracranial subarachnoid space, but, severe cerebral vasospasm is rare complication of the extension of intracranial SAH from a spinal subarachnoid hematoma. A 67-year-old woman started anticoagulant therapy for unstable angina. The next day...

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Autores principales: Nam, Kyoung Hyup, Lee, Jae Il, Choi, Byung Kwan, Han, In Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Neurosurgical Society 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303733/
https://www.ncbi.nlm.nih.gov/pubmed/25628817
http://dx.doi.org/10.3340/jkns.2014.56.6.527
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author Nam, Kyoung Hyup
Lee, Jae Il
Choi, Byung Kwan
Han, In Ho
author_facet Nam, Kyoung Hyup
Lee, Jae Il
Choi, Byung Kwan
Han, In Ho
author_sort Nam, Kyoung Hyup
collection PubMed
description Spinal subarachnoid hemorrhages (SAH) can extend into the intracranial subarachnoid space, but, severe cerebral vasospasm is rare complication of the extension of intracranial SAH from a spinal subarachnoid hematoma. A 67-year-old woman started anticoagulant therapy for unstable angina. The next day, she developed severe back pain and paraplegia. MRI showed intradural and extramedullar low signal intensity at the T2-3, consistent with intradural hematoma. High signal intensity was also noted in the spinal cord from C5 to T4. We removed subarachnoid hematoma compressing the spinal cord. The following day, the patient complained of severe headache. Brain CT revealed SAH around both parietal lobes. Three days later, her consciousness decreased and left hemiplegia also developed. Brain MRI demonstrated multiple cerebral infarctions, mainly in the right posterior cerebral artery territory, left parietal lobe and right watershed area. Conventional cerebral angiography confirmed diffuse severe vasospasm of the cerebral arteries. After intensive care for a month, the patient was transferred to the rehabilitation department. After 6 months, neurologic deterioration improved partially. We speculate that surgeons should anticipate possible delayed neurological complications due to cerebral vasospasm if intracranial SAH is detected after spinal subarachnoid hematoma.
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spelling pubmed-43037332015-01-27 Intracranial Extension of Spinal Subarachnoid Hematoma Causing Severe Cerebral Vasospasm Nam, Kyoung Hyup Lee, Jae Il Choi, Byung Kwan Han, In Ho J Korean Neurosurg Soc Case Report Spinal subarachnoid hemorrhages (SAH) can extend into the intracranial subarachnoid space, but, severe cerebral vasospasm is rare complication of the extension of intracranial SAH from a spinal subarachnoid hematoma. A 67-year-old woman started anticoagulant therapy for unstable angina. The next day, she developed severe back pain and paraplegia. MRI showed intradural and extramedullar low signal intensity at the T2-3, consistent with intradural hematoma. High signal intensity was also noted in the spinal cord from C5 to T4. We removed subarachnoid hematoma compressing the spinal cord. The following day, the patient complained of severe headache. Brain CT revealed SAH around both parietal lobes. Three days later, her consciousness decreased and left hemiplegia also developed. Brain MRI demonstrated multiple cerebral infarctions, mainly in the right posterior cerebral artery territory, left parietal lobe and right watershed area. Conventional cerebral angiography confirmed diffuse severe vasospasm of the cerebral arteries. After intensive care for a month, the patient was transferred to the rehabilitation department. After 6 months, neurologic deterioration improved partially. We speculate that surgeons should anticipate possible delayed neurological complications due to cerebral vasospasm if intracranial SAH is detected after spinal subarachnoid hematoma. The Korean Neurosurgical Society 2014-12 2014-12-31 /pmc/articles/PMC4303733/ /pubmed/25628817 http://dx.doi.org/10.3340/jkns.2014.56.6.527 Text en Copyright © 2014 The Korean Neurosurgical Society http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Nam, Kyoung Hyup
Lee, Jae Il
Choi, Byung Kwan
Han, In Ho
Intracranial Extension of Spinal Subarachnoid Hematoma Causing Severe Cerebral Vasospasm
title Intracranial Extension of Spinal Subarachnoid Hematoma Causing Severe Cerebral Vasospasm
title_full Intracranial Extension of Spinal Subarachnoid Hematoma Causing Severe Cerebral Vasospasm
title_fullStr Intracranial Extension of Spinal Subarachnoid Hematoma Causing Severe Cerebral Vasospasm
title_full_unstemmed Intracranial Extension of Spinal Subarachnoid Hematoma Causing Severe Cerebral Vasospasm
title_short Intracranial Extension of Spinal Subarachnoid Hematoma Causing Severe Cerebral Vasospasm
title_sort intracranial extension of spinal subarachnoid hematoma causing severe cerebral vasospasm
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303733/
https://www.ncbi.nlm.nih.gov/pubmed/25628817
http://dx.doi.org/10.3340/jkns.2014.56.6.527
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