Coincidental cerebral venous thrombosis and subarachnoid haemorrhage related to ruptured anterior communicating artery aneurysm
| Autor: | Irina Mader, Annette Baumgartner, Claudia Neubauer, Stephan Meckel, Michel Rijntjes |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Subarachnoid hemorrhage Anterior cerebral artery stenosis Aneurysm Ruptured Magnetic resonance angiography 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Aneurysm Cerebral vasospasm medicine.artery medicine Anterior cerebral artery Cerebrovascular Imaging Image Processing Computer-Assisted Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Venous Thrombosis medicine.diagnostic_test business.industry Intracranial Aneurysm General Medicine Digital subtraction angiography Middle Aged Subarachnoid Hemorrhage medicine.disease Magnetic Resonance Imaging medicine.anatomical_structure Dural venous sinuses cardiovascular system Female Neurology (clinical) Radiology business Tomography X-Ray Computed 030217 neurology & neurosurgery |
| Popis: | Aneurysmal subarachnoid haemorrhage (SAH) and cerebral venous thrombosis (CVT) are rare cerebrovascular pathologies. Here, we report the extremely rare coincidental presentation of both entities and discuss the likely relationship in aetiology and their optimal management. A female patient presented with headache and progressive neurological deficits. Cranial computed tomography and contrast-enhanced magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) revealed dural venous sinus thrombosis, left-sided frontal and parietal infarcts, and left middle and anterior cerebral artery stenosis. In addition, left hemispheric subarachnoid haemosiderosis was seen on MRI. Following standard anticoagulation therapy for CVT, she represented with acute SAH. Digital subtraction angiography revealed a ruptured anterior communicating artery aneurysm and left middle cerebral artery/anterior cerebral artery vasospasms that were responsive to intra-arterial nimodipine. The latter were already present on the previous MRI, and had most likely prevented the detection of the aneurysm initially. The aneurysm was successfully coil embolised, and the patient improved clinically. Despite this case being an extremely rare coincidence, a ruptured aneurysm should be excluded in the presence of CVT and non-sulcal SAH. A careful consideration of treatment of both pathologies is required, since anticoagulation may have a potentially negative impact on aneurysmal bleeding. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|