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Julian L. Robinson, Charles J. Hall and Carol B. Sedzimir

W ith the decrease in maternal mortality, an increasing number of pregnant women with primarily nonobstetrical diseases is being seen. We are reporting 27 such patients, 26 of whom had spontaneous subarachnoid hemorrhages in their pregnancy and one who developed a third nerve palsy from an internal carotid aneurysm without hemorrhage. These 27 patients were admitted to the Regional Neurosurgical Centre, Walton Hospital, Liverpool, between January, 1954, and July, 1970, during which time 1799 patients with spontaneous subarachnoid hemorrhage were seen

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David G. Changaris, James M. Powers, Phanor L. Perot Jr., G. Douglas Hungerford and George B. Neal

S pontaneous subarachnoid hemorrhage (SAH) with presenting symptoms of sudden, severe headache, papilledema, and neck stiffness usually indicates bleeding from an arterial aneurysm, hypertensive arteriosclerotic vascular disease, or a vascular malformation. 13 Occasionally, a brain tumor can also produce symptomatic SAH. 1, 8, 26 Subependymoma is a rare, benign neoplasm occurring in the recesses of the fourth ventricle and occasionally in the lateral ventricles. 2, 4, 5, 7, 10, 20 Symptoms, if any, usually result either from direct compression of the brain

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Kevin McCoyd, Kevin D. Barron and Robert J. Cassidy

N eurinomas of the cerebellopontine angle usually become clinically significant only when they produce hearing deficit or attain sufficient size to compress and damage other structures. This report concerns an acoustic neurinoma that resulted in the death of the patient from a massive subarachnoid hemorrhage which had dissected into the brain stem and cerebellum. Case Report This 64-year-old right-handed woman had been seeing her physician regularly for 5 years for treatment of mild, asymptomatic systolic hypertension which had responded well to diuretic

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Paul Steinbok, Clarisse L. Dolman and Ken Kaan

B rain tumors occasionally simulate primary intracranial hemorrhages. We report two cases of pineocytoma in patients who were first diagnosed as having subarachnoid hemorrhage (SAH). Case Reports Case 1 At the age of 13 years this previously healthy boy suffered an acute bout of headache, vomiting, and lethargy, which resolved within a month. Shortly afterward, however, severe headache recurred, leading to hospitalization. Course . He had no neurological signs except for neck stiffness. Lumbar puncture yielded bloody cerebrospinal fluid (CSF) with

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John F. Rice, Christopher B. Shields, Charles F. Morris and Byron D. Neely

: Spontaneous subarachnoid hemorrhage associated with spinal cord tumor. Case report. J Neurosurg 40 : 252 – 254 , 1974 Runnels JB, Hanbery JW: Spontaneous subarachnoid hemorrhage associated with spinal cord tumor. Case report. J Neurosurg 40: 252–254, 1974 12. Shapiro RS : Myelography , ed 2 . Chicago : Year Book Medical Publishers , 1968 , pp 455 – 461 Shapiro RS: Myelography, ed 2. Chicago: Year Book Medical Publishers, 1968, pp 455–461 13. Walton JN : Subarachnoid haemorrhage of unusual

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M. Gazi Yasargil, Yasuhiro Yonekawa, Bruno Zumstein and Hans-Jürgen Stahl

C ommunicating hydrocephalus is now a well-recognized complication of subarachnoid hemorrhage (SAH) due to ruptured intracranial aneurysm. It is attributed to an adhesive reaction in the basilar cisterns, over the cerebral convexity, and at the incisural region of the tentorium following SAH. 6, 7, 9, 10, 13, 16 In reporting the results of intracranial operation in a series of 250 aneurysms we noted that communicating hydrocephalus was frequently a problem. 11 This paper reports the clinical features of 28 cases of hydrocephalus out of 280 cases with

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Subarachnoid hemorrhage and cerebrovascular spasm

Morphological study of intracranial arteries based on animal experiments and human autopsies

O. Petter Eldevik, Kristian Kristiansen and Ansgar Torvik

D espite technical advances, there is still a significant mortality and morbidity associated with aneurysm surgery in most neurosurgical centers. This may be due to many causes. Cerebral vasospasm is a common complication and has a high mortality rate. However, constriction of the arteries is not only observed as an effect of the neurosurgical procedure, but is frequently a result of the subarachnoid hemorrhage (SAH) itself. In some cases, preoperative vasospasm may disappear after craniotomy and clipping of the aneurysm. The occurrence of vasospasm

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Joseph F. Cusick, Khang-Cheng Ho and Jay F. Schamberg

associated with the intrathecal injection of chymopapain. 2, 7–10, 14 Subarachnoid hemorrhage (SAH) was a common finding in these studies and was attributed to disruption of the vascular wall of capillaries and veins. Although the clinical risk of serious CNS injury after the inadvertent intrathecal injection of chymopapain in man has been generally recognized, the definition of the causal role of chymopapain requires clarification of two major factors. First, the CNS toxicity of coexisting intrathecal injections of positive contrast agents used during the discography

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Patrick W. McCormick, John McCormick, Joseph M. Zabramski and Robert F. Spetzler

subarachnoid hemorrhage. Neurosurgery 27: 369–372, 1990 6. DeVivo D , Kline E , Dodge PR : Influence of human cercbrospinal fluid on blood coagulation in vitro . Arch Neurol 13 : 615 – 620 , 1965 DeVivo D, Kline E, Dodge PR: Influence of human cercbrospinal fluid on blood coagulation in vitro . Arch Neurol 13: 615–620, 1965 7. Dorsch N , Branston NM , Symon L , et al : Intracranial pressure changes following primate subarachnoid haemorrhage. Neurol Res 11 : 201 – 204 , 1989

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Hans Säveland, Bengt Sonesson, Bengt Ljunggren, Lennart Brandt, Tore Uski, Stefan Zygmunt and Bengt Hindfelt

. Scotti G , Ethier R , Melançon D , et al : Computed tomography in the evaluation of intracranial aneurysms and subarachnoid hemorrhage. Radiology 123 : 85 – 90 , 1977 Scotti G, Ethier R, Melançon D, et al: Computed tomography in the evaluation of intracranial aneurysms and subarachnoid hemorrhage. Radiology 123: 85–90, 1977 34. Suzuki J , Komatsu S , Sato T , et al : Correlation between CT findings and subsequent development of cerebral infarction due to vasospasm in subarachnoid haemorrhage