Very late-onset symptomatic cerebral vasospasm caused by a large residual aneurysmal subarachnoid hematoma--case report.
A 70-year-old female developed delayed ischemic neurological deficits at 35 days after subarachnoid hemorrhage (Hunt and Kosnik grade III, Fisher group 4) caused by a ruptured aneurysm of the left middle cerebral artery. Angiography indicated late-onset cerebral vasospasm probably due to the mass effect of a large hematoma remaining in the sylvian fissure and an intracerebral hematoma after surgery. Patients with a large subarachnoid hematoma after subarachnoid hemorrhage should receive therapy to prevent cerebral vasospasm until the mass effect of the hematoma has diminished.
Yamaguchi
M
M
Department of Neurosurgery, Numazu City Hospital, Shizuoka.
Bun
T
T
Kuwahara
T
T
Kitamura
S
S
D000203:Activities of Daily Living; D000368:Aged; D002533:Cerebral Angiography; D003399:Craniotomy; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000209:etiology* / Q000601:surgery