Combined Treatment of Ruptured Middle Cerebral Artery Aneurysm Followed by Subarachnoid Hemorrhage and Acute Subdural Hematoma in Multiple Aneurysm Disease of Cerebral Blood Vessels: Case Report

Abstract

SUMMARY -Aneurysms of blood vessels at the base of the brain are pathological focal outpouchings, usually found at the branching points of the arteries. Aneurysm can remain silent for life. Clinical presentation is due to rupture and bleeding. In only 1.3% of cases it results in subdural hematoma, which is associated with direct interaction of the aneurysm with the basal arachnoid membrane. Multiple aneurysms are present in 15% to 33% of cases with subarachnoid hemorrhage. Assessment of these patients is more complicated, as there are no specifi c signs to pinpoint/detect the aneurysm that has ruptured. Th is report presents a 44-year-old female patient suff ering from multiple cerebral aneurysm disease, who was urgently treated after rupture by both endovascular (for multiple aneurysms) and surgical (for acute subdural hematoma) approach in the same act under general anesthesia, which resulted in complete recovery of the patient.

Unusual Clinical Course of Neurosarcoidosis Manifested with Acute Hydrocephalus

“…Although the prognosis of neurosarcoidosis is good, particularly when facial nerve is involved, hydrocephalus is associated with a high mortality rate of 75% 12,13 . Benzagmout et al report that after treatment with ven tricular shunt and corticosteroid therapy, acute hydrocephalus associated with neurosarcoidosis was resolved 14,15 .…”

“…Benzagmout et al . report that after treatment with ventricular shunt and corticosteroid therapy, acute hydrocephalus associated with neurosarcoidosis was resolved ( 14 , 15 ).…”

Prognostic value of early glycosylated hemoglobin and blood glucose levels in patients with basal ganglia cerebral hemorrhage

“…A previous report described a 44-yearold woman with multiple cerebral aneurysm disease who was urgently treated after rupture by simultaneous endovascular and surgical approaches under general anesthesia, resulting in complete recovery of the patient. 22 Patients often develop significant cognitive impairment early after acute ICH; this is more frequent in patients of advanced age, female patients, and patients with prior acute ICH. 23 The present study showed that neurological impairment is associated with 30-day mortality.…”