Severe Cerebral Vasospasm Caused by Non-Aneurysmal Subarachnoid Hemorrhage Treatment with Transluminal Balloon Angioplasty

Abstract

Non-aneurysmal subarachnoid hemorrhage (NSAH) is a benign form of subarachnoid hemorrhage (SAH). The angiographic changes of cerebral vasospasm (CVS) are uncommon in patients with this type of SAH. NSAH is uniformly associated with an excellent outcome without associated rebleeding or symptomatic CVS. We report a patient with NSAH who developed severe and diffuse CVS. He was treated with transluminal balloon angioplasty because he has been refractory to conventional treatment measures for CVS.

Key words

Angioplasty - non-aneurysmal subarachnoid hemorrhage - vasospasm

References

• 1 Findlay JM. Vth International Conference on Cerebral Vasospasm: an overview. In: Findlay JM (ed). Cerebral Vasospasm. Proceedings of the Vth International Conference on Cerebral Vasospasm. Amsterdam, Netherlands, Elsevier Science Publishers BV 1993 pp 1-3
• 2 Findlay JM. Cerebral Vasospasm. In: Winn HR (ed). Youmans Neurological Surgery. New York, Saunders 2004 pp 1839-1867
• 3 Gilbert JW, Lee C, Young B. Repeated cerebral pan-angiography in subarachnoid hemorrhage of unknown etiology.  Surg Neurol. 1990;  33 19-21
• 4 Gomez PA, Lobato RD, Rivas JJ, Cabrera A, Sarabia R, Castro S, Castaneda M, Canizal JM. Subarachnoid hemorrhage of unknown etiology.  Acta Neurochir. 1989;  101 35-41
• 5 Nishioka H, Torner JC, Graf CJ, Kassell NF, Sahs AL, Goettler LC. Cooperative study of intracranial aneurysm and subarachnoidal hemorrhage: a long term prognostic study. III. Subarachnoid hemorrhage of undetermined etiology.  Arch Neurol. 1984;  41 1147-1151
• 6 Schwartz TH, Solomon RA. Perimesencephalic non-aneurysmal subarachnoid hemorrhage: review of the literature.  Neurosurgery. 1996;  39 433-440
• 7 Van Calenbergh F, Plets C, Goffin J, Velghe L. Non-aneurysmal subarachnoid hemorrhage: prevalence of perimesencephalic hemorrhage in a consecutive series.  Surg Neurol. 1993;  39 320-323
• 8 Wijdicks EF, Schievink WI. Perimesencephalic nonaneurysmal subarachnoid hemorrhage: first hind of a cause?.  Neurology. 1997;  49 634-636
• 9 Ildan F, Tuna M, Erman T, Gocer AI, Cetinalp E. Prognosis and prognostic factors in nonaneurysmal perimesencephalic hemorrhage: a follow-up study in 29 patients.  Surg Neurol. 2002;  57 160-165
• 10 Van Gijn J, Dongen KJ, Vermeulen M, Hijdra A.. Perimesencephalic hemorrhage: a nonaneurysmal and benign form of subarachnoid hemorrhage.  Neurology. 1985;  35 493-497
• 11 Kassell NF, Helm G, Simmons N, Phillips CD, Cail WS.. Treatment of cerebral vasospasm with intra-arterial papaverine.  J Neurosurg. 1992;  77 848-852
• 12 Matsumaru Y, Yanaka K, Morui A, Sato H, Kamezaki T, Nose T.. Significance of a small bulge on basilar artery in patients with perimesencephalic non-aneurysmal subarachnoid hemorrhage.  J Neurosurg. 2003;  98 426-429
• 13 Rinkel GJ, Wijdicks EF, Vermeulen M, Hasan D, Brouwers PJ, Gijn J. The clinical course of perimesencephalic nonaneurysmal subarachnoid hemorrhage.  Ann Neurol. 1991;  29 463-468
• 14 Schievink WI, Wijdicks EF.. Origin of pretruncal nonaneurysmal subarachnoid hemorrhage: ruptured vein, perforating artery, or intramural hematoma?.  Mayo Clin Proc. 2000;  75 1169-1173
• 15 Canhao P, Pinto AN, Pinho e Melo T, Ferro JM, Campos JG, Trindade AM, Antunes JL. Hemorrhagia perimesencefalica.  Acta Med Port. 1992;  5 473-475
• 16 Rinkel GJ, Wijdicks EF, Vermeulen M, Hageman LM, Tans JT, Gijn J van.. Outcome in perimesencephalic (nonaneurysmal) subarachnoid hemor-rhage: a follow-up study in 37 patients.  Neurology. 1990;  40 1130-1132
• 17 Sheehan JM, Cloft H, Kassell NF. Symptomatic delayed arterial spasm following non-aneurysmal perimesencephalic subarachnoid hemorrhage: a case report and review of the literature.  Acta Neurochir (Wien). 2000;  142 709-712
• 18 Kassell NF, Torner JC, Haley Jr  EC, Jane JA, Adams HP, Kongable GL. The international co-operative study on the timing of aneurysm surgery. Part I: Overall management results.  J Neurosurg. 1990;  73 18-36
• 19 Kassell NF, Peerless SJ, Durward QJ, Beck DW, Drake CG, Adams HP.. Treatment of ischemic deficit from vasospasm with intravascular volume expansion and induced arterial hypertension.  Neurosurgery. 1982;  11 337-343
• 20 Ecker A, Riemenschneider PA.. Arteriographic demonstration of spasm of the intracranial arteries, with special reference to saccular arterial aneurysms.  J Neurosurg. 1951;  8 660-667
• 21 Eskridge JM, Newell DW, Winn HR. Endovascular treatment of vasospasm.  Neurosurg Clin North Am. 1994;  5 437-447
• 22 Le Roux PD, Mayberg MR.. Management of vasospasm: angioplasty. In: Ratcheson RA, Wirth FP (eds). Ruptured Cerebral Aneurysms: Perioperative Management. Concepts in Neurosurgery. Vol. 6 Baltimore, William & Wilkins 1994 pp 155-167
• 23 Le Roux PD, Newell DW, Eskridge J, Mayberg MR, Winn HR. Severe symptomatic vasospasm: the role of immediate postoperative angioplasty.  J Neurosurg. 1994;  80 224-229
• 24 Muizelaar JP, Zwienenberg M, Rudisill NA, Hecht ST.. The prophylactic use of transluminal balloon angioplasty in patient with Fisher Grade 3 subarachnoid hemorrhage: pilot study.  J Neurosurg. 1999;  91 51-58
• 25 Zubkov YN, Nikiforov BM, Shustin VA. Balloon catheter technique of dilatation of constricted cerebral arteries after aneurysmal SAH.  Acta Neurochir (Wien). 1984;  70 65-79
• 26 Coyne TJ, Montanera WJ, MacDonald RL, Wallace MC. Percutaneous transluminal angioplasty for cerebral vasospasm after subarachnoid hemorrhage.  Can J Surg. 1994;  37 391-396
• 27 Eskridge JM, McAuliffe W, Song JK, Deliganis AV, Newell DW, Lewis DH, Mayberg MR, Winn HR. Balloon angioplasty for the treatment of vasospasm: results of the first 50 cases.  Neurosurgery. 1998;  42 510-517
• 28 Morgan MK, Sekhon L, Halcrow S, Grinnell V, Sorby W. Effective management of cerebral vasospasm with balloon angioplasty after failed papaverine angioplasty: case report.  J Clin Neurosci. 1996;  3 162-165
• 29 Higashida RT, Halbach VV, Cahan LD, Brant-Zawadzki M, Barnwell S, Dowd C, Hieshima GB. Transluminal angioplasty for treatment of intracranial arterial vasospasm.  J Neurosurg. 1989;  71 648-653
• 30 Newell DW, Eskridge JM, Mayberg MR, Grady MS, Winn HR. Angioplasty for the treatment of symptomatic vasospasm following subarachnoid hemorrhage.  J Neurosurg. 1989;  71 654-660
• 31 Castaneda-Zuniga WR, Laerum F, Rysavy J, Rusnak B, Amplatz K.. Paralysis of arteries by intraluminal balloon dilatation.  Radiology. 1982;  144 75-76
• 32 Macdonald RL, Zhang J, Han H. Angioplasty reduces pharmacologically mediated vasoconstriction in rabbit carotid arteries with and without vasospasm.  Stroke. 1995;  26 1053-1060
• 33 Macdonald RL, Wallace MC, Montanera WJ, Glen JA. Pathological effects of angioplasty on vasospastic carotid arteries in a rabbit model.  J Neurosurg. 1995;  83 111-117
• 34 Pile-Spellman J, Berenstein A, Bun T, Oot R, Baker K, Peterson J. Angioplasty of canine cerebral arteries.  AJNR Am J Neuroradiol. 1987;  8 938 , [Abstract]
• 35 Wolf GL, Lentini EA, LeVeen RF. Reduced vasoconstrictor response after angioplasty in normal rabbit aortas.  AJR Am J Roentgenol. 1984;  142 1023-1025
• 36 Yamamoto Y, Smith RR, Bernanke DH. Mechanism of action of balloon angioplasty in cerebral vasospasm.  Neurosurgery. 1992;  30 1-6
• 37 Friedman JA, Meyer FB, Wetjen NM, Nichols DA. Balloon angioplasty to treat vasospasm after transsphenoidal surgery. Case illustration.  J Neurosurg. 2001;  95 353
• 38 Bejjani GK, Sekhar LN, Yost AM, Bank WO, Wright DC.. Vasospasm after cranial base tumor resection: pathogenesis, diagnosis, and therapy.  Surg Neurol. 1999;  52 577-583
• 39 Linskey ME, Horton JA, Rao GR, Yonas H.. Fatal rupture of the intracranial carotid artery during transluminal angioplasty for vasospasm induced by subarachnoid hemorrhage.  J Neurosurg. 1991;  74 985-990
• 40 Song JK, Eskridge JM. Intracranial angioplasty and thrombolysis.  Neurosurg Clin North Am. 2000;  11 49-65
• 41 Volk EE, Prayson RA, Perl J II. Autopsy findings of fatal complication of posterior cerebral circulation angioplasty.  Arch Pathol Lab Med. 1997;  121 738-740

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