The clinical and neuroradiological features of patients of coexisting atraumatic convexity subarachnoid hemorrhage and large artery atherosclerosis stroke

Chai, Jingyan; Nie, Hongbing; Wu, Xue-Ru; Guan, Yanqin; Dai, Tingmin; Shen, Yali

doi:10.1097/md.0000000000028155

Cited by 2 publications

(1 citation statement)

References 19 publications

(56 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, it is necessary to consider that patients with AF are at greater risk of adverse events and poor prognosis, regardless of concomitant anticoagulant therapy [100]. Atherosclerosis is to be considered as a condition that can alternatively cause ischemic or hemorrhage, so its progression is strongly associated with possible dual manifestations of thrombosis and hemorrhage [101]. Intracranial hemorrhage is the only pathological form that unites some rather rare conditions, including cerebral amyloid angiopathy, reversible cerebral vasoconstriction syndrome, and reversible posterior leukoencephalopathy syndrome [102].…”

Section: Individual Risk Factors In Patients With Hemorrhagic Transfo...mentioning

confidence: 99%

Hemorrhagic Coagulation Disorders and Ischemic Stroke: How to Reconcile Both?

Crispino

2023

Neurology International

View full text Add to dashboard Cite

Coagulation and fibrinolytic system disorders are conditions in which the blood’s ability to clot is impaired, resulting in an increased risk of thrombosis or bleeding. Although these disorders are the expression of two opposing tendencies, they can often be associated with or be a consequence of each other, contributing to making the prognosis of acute cerebrovascular events more difficult. It is important to recognize those conditions that are characterized by dual alterations in the coagulation and fibrinolytic systems to reduce the prognostic impact of clinical conditions with difficult treatment and often unfortunate outcomes. Management of these individuals can be challenging, as clinicians must balance the need to prevent bleeding episodes with the potential risk of clot formation. Treatment decisions should be made on an individual basis, considering the specific bleeding disorder, its severity, and the patient’s general medical condition. This review aims to deal with all those forms in which coagulation and fibrinolysis represent two sides of the same media in the correct management of patients with acute neurological syndrome. Precision medicine, personalized treatment, advanced anticoagulant strategies, and innovations in bleeding control represent future directions in the management of these complex pathologies in which stroke can be the evolution of two different acute events or be the first manifestation of an occult or unknown underlying pathology.

show abstract

Section: Individual Risk Factors In Patients With Hemorrhagic Transfo...mentioning

confidence: 99%

Hemorrhagic Coagulation Disorders and Ischemic Stroke: How to Reconcile Both?

Crispino

2023

Neurology International

View full text Add to dashboard Cite

show abstract

Convexity subarachnoid hemorrhage revealed contralateral internal carotid artery dissection due to Eagle syndrome: a case report

Obara,

Furuta,

Yagi

et al. 2024

BMC Neurol

View full text Add to dashboard Cite

Background Atraumatic localized convexity subarachnoid hemorrhage (cSAH) is an uncommon form of nonaneurysmal subarachnoid hemorrhage characterized by bleeding limited to the cerebral convexities. Ipsilateral cSAH can result from a variety of causes, such as internal carotid artery stenosis, obstruction, and dissection, although concomitant contralateral cSAH is exceptionally rare. In this case, the initial findings of cSAH led us to discovering contralateral internal carotid artery dissection (ICAD) and an elongated styloid process (ESP). ESP is recognized as a risk factor for ICAD, which is a hallmark of Eagle syndrome. This sequence of findings led to the diagnosis of Eagle syndrome, illustrating a complex and intriguing interplay between cerebrovascular conditions and anatomical variations. Case presentation A 47-year-old Japanese woman experienced acute onset of headache radiating to her neck, reaching its zenith approximately two hours after onset. Given the intractable nature of the headache and its persistence for three days, she presented to the emergency department. Neurological examination revealed no abnormalities, and the coagulation screening parameters were within normal ranges. Brain computed tomography (CT) revealed right parietal cSAH, while CT angiography (CTA) revealed ICAD and an ESP measuring 30.1 mm on the left side, positioned only 1.4 mm from the dissected artery. The unusual occurrence of contralateral cSAH prompted extensive and repeated imaging reviews that excluded reversible cerebral vasoconstriction syndrome (RCVS), leading to a diagnosis of left ICAD secondary to Eagle syndrome. The patient underwent conservative management, and the dissected ICA spontaneously resolved. The patient has remained recurrence-free for two and a half years. Conclusions Managing cSAH requires diligent investigation for ICAD, extending beyond its identification to explore underlying causes. Recognizing Eagle syndrome, though rare, as a potential etiology of ICAD necessitates the importance of evaluating ESPs. The method for preventing recurrent cervical artery dissection due to Eagle syndrome is controversial; however, conservative management is a viable option.

show abstract

The clinical and neuroradiological features of patients of coexisting atraumatic convexity subarachnoid hemorrhage and large artery atherosclerosis stroke

Cited by 2 publications

References 19 publications

Hemorrhagic Coagulation Disorders and Ischemic Stroke: How to Reconcile Both?

Hemorrhagic Coagulation Disorders and Ischemic Stroke: How to Reconcile Both?

Convexity subarachnoid hemorrhage revealed contralateral internal carotid artery dissection due to Eagle syndrome: a case report

Contact Info

Product

Resources

About