11/383. Tentorial dural arteriovenous fistulae: endovascular treatment with transvenous coil embolisation.Tentorial arteriovenous dural fistulae are uncommon. They are aggressive lesions: of all intracranial dural fistulae they are the most likely to present with haemorrhage. Treatment options include surgical excision or interruption of leptomeningeal draining veins and arterial embolisation in isolation or in combination with surgery. There has been one case report of treatment by percutaneous transvenous coil embolisation. We describe successful transvenous coil embolisation of two tentorial dural fistulae presenting with subarachnoid haemorrhage.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
12/383. Ruptured distal anterior choroidal artery aneurysm presenting with casting intraventricular haemorrhage.This report describes a rare case of a distal anterior choroidal artery aneurysm which developed intraventricular haemorrhage without subarachnoid haemorrhage as shown on computerized tomographic (CT) scan. A 69-year-old hypertensive man suddenly became unconscious. An emergency CT scan showed a severe intraventricular haemorrhage and a small round low-dense lesion within the haematoma at the right trigone. The haematoma with obstructive hydrocephalus made the lateral ventricles larger on the right than on the left. CT scan could not detect any subarachnoid haemorrhage. Right interal carotid angiography revealed a saccular aneurysm at the plexal point of the right anterior choroidal artery. We approached the aneurysm and the small round lesion through the trigone via a right temporo-occipital corticotomy. We could clip the aneurysmal neck and remove the intraventricular haematoma and the papillary cystic mass (corresponding to the small round lesion on CT scan) totally in one sitting. Histological examination revealed the aneurysm to be a true one and the papillary cystic mass to be a choroid plexus cyst.- - - - - - - - - - ranking = 4keywords = haemorrhage (Clic here for more details about this article) |
13/383. MRI in cerebral intraventricular hemorrhage: analysis of 50 consecutive cases.MRI of intraventricular haemorrhage (IVH) has not been studied formally. We aimed to describe the degradation rate and patterns shown on 1.5 T MRI in IVH, comparing them to other coexisting brain hemorrhage. We studied 50 consecutive cases using T1-, proton-density, and T2-weighted images. IVH was seen in two forms: layered (free-flowing in ventricles) (37 cases) and/or clotted (31). Both were best shown by proton-density image. Layered IVH was seen in the dependent portions of the lateral ventricles with fluid ("blood-CSF") levels, degrading more slowly than both clotted IVH and intraparenchymal hemorrhages (IPH) (acute blood products persisting for several more days; P < 0.05). Clotted IVH degraded at a rate comparable to IPH. IVH cleared rapidly and did not form hemosiderin. subarachnoid hemorrhage (SAH) cleared faster and was less conspicuous than IVH. Hypertensive (22), aneurysmal (11), traumatic (2), idiopathic (9), or vascular malformation-related (6) IVH were seen. IVH coexisted with IPH (30) or SAH (12), or both (12). The high rate of layering with blood-CSF levels in IVH is most likely due to different densities of blood components and CSF and the fibrinolytic capability of the latter. Delayed degradation of layered IVH probably reflects high intraventricular oxygen and glucose content. Further study is necessary to determine if MRI characteristics of IVH are helpful in excluding other intraventricular diseases such as neoplasia and pyocephalus.- - - - - - - - - - ranking = 0.5keywords = haemorrhage (Clic here for more details about this article) |
14/383. Haemorrhage in the labyrinth caused by anticoagulant therapy: case report.We report a patient who experienced a severe vertiginous episode with bilateral tinnitus and progressive right-sided hearing loss. She had Marfan's disease and was on anticoagulant treatment. The fluid in the labyrinth gave higher signal than cerebrospinal fluid on T1-weighted images, suggesting haemorrhage. The radiological follow-up is discussed.- - - - - - - - - - ranking = 0.5keywords = haemorrhage (Clic here for more details about this article) |
15/383. April 1999--44 year old man with a bleeding intracerebral tumor.A 44 year-old man presented with a three month history of increasing headache and evolving left sided hemiparesis that culminated in an haemorrhage into an intracerebral tumour which was partially resected. Histologic, immunohistochemical, electron microscopic and molecular studies are supportive of a diagnosis of primary embryonal rhabdomyosarcoma. While primary rhabdomyosarcoma of the central nervous system is rare, and 72% of previously reported cases are in the paediatric population, there appears to be subset of these tumours occurring supratentorially in the adult.- - - - - - - - - - ranking = 0.5keywords = haemorrhage (Clic here for more details about this article) |
16/383. Idiopathic intracranial haemorrhage in the fetus.Intracranial haemorrhage in the fetus has been reported with associated mortality and morbidity. This case report describes idiopathic subdural haematomas diagnosed at 32 weeks of gestation, with delivery by caesarean section of a live male infant in good condition at 34 weeks.- - - - - - - - - - ranking = 2.5keywords = haemorrhage (Clic here for more details about this article) |
17/383. Cerebellar haemorrhage after evacuation of an acute supratentorial subdural haematoma.Recent reports have highlighted the unusual complication of distant cerebellar haemorrhage after supratentorial craniotomy, with only 25 previous cases reported in the literature. Nearly all reported cases occurred after craniotomy for temporal lobectomy or for deep seated intracerebral pathology requiring brain retraction and removal of CSF at surgery. Only one previous case of a cerebellar haemorrhage after evacuation of an extracerebral fluid collection has been reported. We describe the case of a cerebellar haemorrhage complicating the evacuation of an acute/subacute supratentorial subdural haematoma in a 83-year-old woman. The literature is reviewed and possible mechanisms of haemorrhage discussed.- - - - - - - - - - ranking = 4keywords = haemorrhage (Clic here for more details about this article) |
18/383. Transcortical sensory aphasia due to a left frontal subcortical haemorrhage.A case of transcortical sensory aphasia caused by a cerebral haemorrhage in the left frontal lobe is presented. A 72-year-old right-handed woman was admitted to the hospital, with a history of acute onset of speech disturbance and headache. On initial assessment, her spontaneous speech was fluent. She had no difficulty initiating speech, articulated normally, and did not exhibit logorrhea. Her ability to repeat phonemes and short sentences (5-6 words) was fully preserved, however she had severe difficulty with visual recognition of words, and with aural comprehension at the word level, although she was able to read words aloud. Computed tomography and magnetic resonance imaging showed cerebral haemorrhage in the left frontal lobe, involving the superior and middle frontal gyrus. Single photon emission CT revealed a wider area of low perfusion over the entire left frontal lobe, including the superior, middle and inferior frontal gyrus. The aphasia symptoms, mainly poor comprehension, disappeared quickly several weeks after the event. This may have been due to a reduction in the size of the haematoma and a resolution of the oedema around the haematoma. Clinically, the transcortical sensory aphasia in this case was indistinguishable from that caused by damage to the posterior language areas. Further case reports of transcortical sensory aphasia associated with frontal lobe lesions would help to confirm whether a relatively rapid recovery is characteristic in cases such as this.- - - - - - - - - - ranking = 3keywords = haemorrhage (Clic here for more details about this article) |
19/383. Management of penetrating injury to the petrous internal carotid artery: case report.We report the management of a penetrating foreign body injury to the neck with a length of fencing wire traversing the internal carotid artery within the petrous temporal bone and entering the middle cranial fossa. Discussion points include methods of haemorrhage control, as well as ligation versus repair or bypass as the definitive treatment.- - - - - - - - - - ranking = 0.5keywords = haemorrhage (Clic here for more details about this article) |
20/383. Unilateral posthaemorrhagic hydrocephalus in the neonatal period or later in infancy.Five infants who developed unilateral hydrocephalus associated with antenatal or perinatal intraventricular haemorrhage (IVH) in the neonatal period or later in infancy are reported. Unilateral hydrocephalus occurred following discharge home in four of our five cases, two of whom had been treated during the neonatal period with either serial lumbar punctures or punctures from a Rickham reservoir. An obstruction at the level of the foramen of Monro following a large subependymal matrix bleed appeared to be the underlying aetiology. These data suggest that infants who suffer a predominantly unilateral IVH, with or without parenchymal involvement, can subsequently develop unilateral hydrocephalus. Cranial ultrasound examinations should be repeated at regular intervals during the first year of life, as unilateral hydrocephalus can still develop after a period of apparent stabilization.- - - - - - - - - - ranking = 0.5keywords = haemorrhage (Clic here for more details about this article) |
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