Journal article
Quadrigeminal perimesencephalic subarachnoid hemorrhage
Clinical neurology and neurosurgery, Vol.137, pp.67-71
10/2015
DOI: 10.1016/j.clineuro.2015.06.018
PMID: 26151343
Abstract
•Three patients with QPSAH are presented.•QPSAH comprised 11% (2/19) of cases of nonaneurysmal PSAH.•Quadrigeminal and pretruncal nonaneurysmal SAH may share a common etiology.•One patient with QPSAH had a posterior circulation aneurysm.•Diagnosis of nonaneurysmal QPSAH requires multiple negative catheter angiograms.
A variant of perimesencephalic subarachnoid hemorrhage (PSAH) has been described characterized by blood centered in the quadrigeminal cistern and limited to the superior vermian and perimesencephalic cisterns. Herein, three cases of quadrigeminal PSAH are presented.
Medical records of all patients who underwent digital subtraction angiography for evaluation of non-traumatic SAH between July 2002 and April 2012 were reviewed. Patients with anterior circulation aneurysms were excluded. Two blinded reviewers identified admission noncontrast CT scans with pretruncal and quadrigeminal patterns of PSAH.
The total cohort included 106 patients: 53% (56/106) with one or more negative digital subtraction angiograms and 47% (50/106) with posterior circulation or posterior communicating artery aneurysms. Three patients with quadrigeminal PSAH were identified, two with nonaneurysmal SAH and one with a posterior circulation aneurysm. Seventeen patients (16%; 17/106) with pretruncal PSAH were identified, none of whom were found to have an aneurysm. The quadrigeminal pattern comprised 11% (2/19) of cases of pretruncal or quadrigeminal nonaneurysmal PSAH.
A small subset of patients with nonaneurysmal PSAH present with blood centered in the quadrigeminal cistern, and the etiology of this pattern may be similar to that of the classic pretruncal variant. However, patients with quadrigeminal PSAH must still undergo thorough vascular imaging, including at least two digital subtraction angiograms, to exclude a ruptured aneurysm.
Details
- Title: Subtitle
- Quadrigeminal perimesencephalic subarachnoid hemorrhage
- Creators
- Adam N Wallace - Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Saint Louis, MO 63110, United StatesRoss Vyhmeister - Washington University School of Medicine, Saint Louis, MO, United StatesRyan Viets - Sharp Grossmont Hospital, San Diego, CA, United StatesJustin T Whisenant - Texas Radiology Associates, Plano, TX, United StatesArindam R Chatterjee - Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Saint Louis, MO 63110, United StatesAkash P Kansagra - Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Saint Louis, MO 63110, United StatesDeWitte T Cross - Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Saint Louis, MO 63110, United StatesChristopher J Moran - Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Saint Louis, MO 63110, United StatesColin P Derdeyn - Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Saint Louis, MO 63110, United States
- Resource Type
- Journal article
- Publication Details
- Clinical neurology and neurosurgery, Vol.137, pp.67-71
- Publisher
- Elsevier B.V
- DOI
- 10.1016/j.clineuro.2015.06.018
- PMID
- 26151343
- ISSN
- 0303-8467
- eISSN
- 1872-6968
- Language
- English
- Date published
- 10/2015
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984013204502771
Metrics
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