title: Cerebral infarction secondary to vasospasm after perimesencephalic subarachnoid hemorrhage.
abstract: Perimesencephalic subarachnoid hemorrhage (pSAH) has been described as a distinct form of subarachnoid hemorrhage (SAH) associated with good outcomes. We report a 48-year-old female who developed cerebral infarction due to severe diffuse vasospasm following pSAH. The patient presented with non-aneurysmal pSAH and was discharged home on day 5. However, one week later she developed an acute onset of right hemiparesis. A brain MRI showed acute infarctions on diffusion weighted imaging and her cerebral angiogram showed diffuse vasospasm. The patient received intra-arterial diltiazem and hypervolemic-hypertensive-hemodilution therapy with resulting resolution of the vasospasm and hemiparesis. While not as common as in SAH, there is a potential for the occurrence of cerebral infarction due to vasospasm after pSAH.
authors.affiliation: Department of Neurology, Jackson Memorial Hospital/University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: A
authors.initials: A
authors.lastname: Fernandez
authors.forename: R L
authors.initials: RL
authors.lastname: Bond
authors.forename: M A
authors.initials: MA
authors.lastname: Aziz-Sultan
authors.forename: S E
authors.initials: SE
authors.lastname: Olvey
authors.forename: H S
authors.initials: HS
authors.lastname: Mangat
mesh_terms: D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000150:complications; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D014057:Tomography, X-Ray Computed; D020301:Vasospasm, Intracranial / Q000150:complications*