Hemorragia subaracnóidea perimesencefálica não-aneurismática: apresentação de caso e revisão de literatura

Tsubouchi, Mário H.; Arruda, Walter O.; Ramina, Ricardo; Meneses, Murilo S.; Pedrozo, Ari A.; Favorito, Luiz F.; Clemente, Rogério S.

doi:10.1590/S0004-282X1994000100014

Resumos

Os autores apresentam um caso de hemorragia subaracnóidea perimesencefálica não aneurismática em um paciente masculino de 42 anos, com excelente evolução clínica. É realizada revisão da literatura, sendo apresentados aspectos clínicos e neurorradiológicos desta entidade benigna.

hemorragia subaracnóidea não-aneurismática; aneurisma cerebral; acidente vascular cerebral hemorrágico; hemorragia subaracnóidea perimesencefálica

A 42 year-old man with subarachnoid hemorrhage was admitted in our Service (Hunt & Hess grade II). CT-scan disclosed predominantly perimesencephalic subarachnoid hemorrhage. Digital subtraction angiographic study did not disclose either cerebral aneurysm or any other potential site of intracranial bleeding. The evolution was uneventful. A DSA was repeated one month later and was negative. Four months later, the patient was asymptomatic. The authors review the literature and emphasize the importance in recognizing this benign clinical form of nonaneurysmatic subarachnoid hemorrhage.

nonaneurysmatic perimesencephalic hemorrhage; cerebral aneurysm; subarachnoid hemorrhage

Hemorragia subaracnóidea perimesencefálica não-aneurismática: apresentação de caso e revisão de literatura

Nonaneurysmatic perimesencephalic hemorrhage: a case report and review of the literature

Mário H. Tsubouchi^I; Walter O. Arruda^I; Ricardo Ramina^II; Murilo S. Meneses^II; Ari A. Pedrozo^II; Luiz F. Favorito^III; Rogério S. Clemente^III

^IUnidade de Ciências Neurológicas, Hospital das Nações, Curitiba: Neurologista

^IIUnidade de Ciências Neurológicas, Hospital das Nações, Curitiba: Neurologista

Neurocirurgião

^IIIUnidade de Ciências Neurológicas, Hospital das Nações, Curitiba: Neurologista

Especializando em Neurocirurgia

RESUMO

Os autores apresentam um caso de hemorragia subaracnóidea perimesencefálica não aneurismática em um paciente masculino de 42 anos, com excelente evolução clínica. É realizada revisão da literatura, sendo apresentados aspectos clínicos e neurorradiológicos desta entidade benigna.

Palavras-chaves: hemorragia subaracnóidea não-aneurismática, aneurisma cerebral, acidente vascular cerebral hemorrágico, hemorragia subaracnóidea perimesencefálica.

SUMMARY

A 42 year-old man with subarachnoid hemorrhage was admitted in our Service (Hunt & Hess grade II). CT-scan disclosed predominantly perimesencephalic subarachnoid hemorrhage. Digital subtraction angiographic study did not disclose either cerebral aneurysm or any other potential site of intracranial bleeding. The evolution was uneventful. A DSA was repeated one month later and was negative. Four months later, the patient was asymptomatic. The authors review the literature and emphasize the importance in recognizing this benign clinical form of nonaneurysmatic subarachnoid hemorrhage.

Key-words: nonaneurysmatic perimesencephalic hemorrhage, cerebral aneurysm, subarachnoid hemorrhage.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 20-julho-1993.

Estudo apresentado como Tema Livre no XV Congresso Brasileiro de Neurologia (Porto Alegre, RS, 1992).

Dr. Mário H. Tsuboushi - Rua Raphael Papa 10 - 82530-190 Curitiba PR - Brasil.

1. Adams HP Jr, Kassel NF, Torner JC, Sahs AL Computed tomographic and clinical correlations in recent aneurysmal subarachoid hemorrhage: a preliminary report of the Cooperative Aneurysm Study. Neurology 1983, 33: 981-988.
2. Adams HP, Gordon DL. Nonaneurysmal subarachnoid hemorrhage. Ann Neurol 1991, 29: 461-462.
3. Alexander MSM, Dias PS, Uttley D. Spontaneous subarachnoid hemorrhage and negative cerebral panangiography: review of 140 cases. J Neurosurg 1986, 64: 537-542.
4. Beguelin C, Seiler R. Subarachonoid hemorrhage with normal panangiography. Neurosurgery 1983, 13: 409-411.
5. Biller J, Godersky JC, Adams HP. Management of aneurysmal subarachnoid hemorrhage. Stroke 1988, 19: 1300-1305.
6. Bozzola FG, Gorelick PB, Jensen JM. Epidemiology of intracranial hemorrhage. Neuroimag Clin N Am 1992, 2: 1-10.
7. Brismar J, Sundbarg G. Subarachnoid hemorrhage of unknown origin: prognosis and prognostic factors. J Neurosurg 1985, 63: 349-354.
8. Cioffi F, Pasqualin A, Cavazzani P, Da Pian R. Subarahnoid hemorrhage of unknown origin: clinical and tomographical aspects. Acta Neurochir 1989, 97: 31-39.
9. Giombini S, Bruzzone MG, Plunchino F. Subarachnoid hemorrhage of unexplained cause. Neurosurgery 1988, 22: 313-316.
10. Hayward RD. Subarachnoid haemorrhage of unknown aetilogy: a clinical and radiological study of 51 cases. J Neurol Neurosurg Psychiatry 1977, 40: 926-931.
11. Nishioka H, Torner JC, Kassel NF, Sahs AI, Goettler LC. Cooperative study of intracranial aneurysms and subarachnoid hemorrhage: a long-term prognostic study. Arch Neurol 1984, 41: 1147-1151.
12. Rinkel GJE, Wijdicks EFM, Vermeulen M, Hageman LH, Tans JTJ, van Gijn J. Outcome in perimesencephalic (nonaneurysmal) subarachnoid haemorrhage: a follow-up study in 37 patients. Neurology 1990, 40: 1130-1132.
13. Rinkel GJE, Wijducks EFM, Hasan D, Kienstra GEM, Franke CI, Hageman LM, Vermeulen M, van Gijn J. Outcome in patients with subarachnoid haemorrhage and angiographic according to pattern of haemorrhage on computed tomography. Lancet 1991, 338: 964-968.
14. Rinkel GJE, Wijdicks EFM, Vermeulen M, Hasan D, Brouwers PJAM, van Gijn J. The clinical course of perimesencephalic nonaneurysmal subarachnoid hemorrhage. Ann Neurol 1991, 29: 463-468.
15. Rinkel GJE, Widjdicks EFM, Vermeulen M, Hasan D, Brouwers PJAM, van Gijn J. Acute hydrocephalus in nonaneurysmal perimesencephalic hemorrhage: evidence of CSF block at the tentorial hiatus. Neurology 1992, 42: 1805-1807.
16. Ruelle A, Lasio G, Boccardo M, Gottlieb A, Severi P. Long-term prognosis of subarachnoid hemorrhages of unknown etiology. J Neurology 1985, 232: 277-279.
17. Solomon RA, Fink ME. Current strategies for the management of aneurysmal subarachnoid hemorrhage. Arch Neurol 1987, 44: 769-774.
18. Van Gijn J. Subarachnoid hemorrhage. Lancet 1992, 339: 653-655.
19. Van Gijn J, van Dogen KJ, Vermeulen M, Hijdra A. Peri mesencephalic hemorrhage: a nonaneurysmal and benign form of subarachnoid hemorrhage. Neurology 1985, 35: 493-497.
20. Vermeulen M, van Gijn J. The diagnosis of subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry 1990, 53: 365-372.
21. Watanbe AT, Mackey JK, Lufkin RB. Imaging diagnosis and temporal appearance of subarachnoid hemorrhage. Neuroimag Clin N Am 1992, 2: 53-59.

Datas de Publicação

Publicação nesta coleção
19 Jan 2011
Data do Fascículo
Mar 1994

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Adams HP Jr, Kassel NF, Torner JC, Sahs AL Computed tomographic and clinical correlations in recent aneurysmal subarachoid hemorrhage: a preliminary report of the Cooperative Aneurysm Study. Neurology 1983, 33: 981-988.

[2] 2. Adams HP, Gordon DL. Nonaneurysmal subarachnoid hemorrhage. Ann Neurol 1991, 29: 461-462.

[3] 3. Alexander MSM, Dias PS, Uttley D. Spontaneous subarachnoid hemorrhage and negative cerebral panangiography: review of 140 cases. J Neurosurg 1986, 64: 537-542.

[4] 4. Beguelin C, Seiler R. Subarachonoid hemorrhage with normal panangiography. Neurosurgery 1983, 13: 409-411.

[5] 5. Biller J, Godersky JC, Adams HP. Management of aneurysmal subarachnoid hemorrhage. Stroke 1988, 19: 1300-1305.

[6] 6. Bozzola FG, Gorelick PB, Jensen JM. Epidemiology of intracranial hemorrhage. Neuroimag Clin N Am 1992, 2: 1-10.

[7] 7. Brismar J, Sundbarg G. Subarachnoid hemorrhage of unknown origin: prognosis and prognostic factors. J Neurosurg 1985, 63: 349-354.

[8] 8. Cioffi F, Pasqualin A, Cavazzani P, Da Pian R. Subarahnoid hemorrhage of unknown origin: clinical and tomographical aspects. Acta Neurochir 1989, 97: 31-39.

[9] 9. Giombini S, Bruzzone MG, Plunchino F. Subarachnoid hemorrhage of unexplained cause. Neurosurgery 1988, 22: 313-316.

[10] 10. Hayward RD. Subarachnoid haemorrhage of unknown aetilogy: a clinical and radiological study of 51 cases. J Neurol Neurosurg Psychiatry 1977, 40: 926-931.

[11] 11. Nishioka H, Torner JC, Kassel NF, Sahs AI, Goettler LC. Cooperative study of intracranial aneurysms and subarachnoid hemorrhage: a long-term prognostic study. Arch Neurol 1984, 41: 1147-1151.

[12] 12. Rinkel GJE, Wijdicks EFM, Vermeulen M, Hageman LH, Tans JTJ, van Gijn J. Outcome in perimesencephalic (nonaneurysmal) subarachnoid haemorrhage: a follow-up study in 37 patients. Neurology 1990, 40: 1130-1132.

[13] 13. Rinkel GJE, Wijducks EFM, Hasan D, Kienstra GEM, Franke CI, Hageman LM, Vermeulen M, van Gijn J. Outcome in patients with subarachnoid haemorrhage and angiographic according to pattern of haemorrhage on computed tomography. Lancet 1991, 338: 964-968.

[14] 14. Rinkel GJE, Wijdicks EFM, Vermeulen M, Hasan D, Brouwers PJAM, van Gijn J. The clinical course of perimesencephalic nonaneurysmal subarachnoid hemorrhage. Ann Neurol 1991, 29: 463-468.

[15] 15. Rinkel GJE, Widjdicks EFM, Vermeulen M, Hasan D, Brouwers PJAM, van Gijn J. Acute hydrocephalus in nonaneurysmal perimesencephalic hemorrhage: evidence of CSF block at the tentorial hiatus. Neurology 1992, 42: 1805-1807.

[16] 16. Ruelle A, Lasio G, Boccardo M, Gottlieb A, Severi P. Long-term prognosis of subarachnoid hemorrhages of unknown etiology. J Neurology 1985, 232: 277-279.

[17] 17. Solomon RA, Fink ME. Current strategies for the management of aneurysmal subarachnoid hemorrhage. Arch Neurol 1987, 44: 769-774.

[18] 18. Van Gijn J. Subarachnoid hemorrhage. Lancet 1992, 339: 653-655.

[19] 19. Van Gijn J, van Dogen KJ, Vermeulen M, Hijdra A. Peri mesencephalic hemorrhage: a nonaneurysmal and benign form of subarachnoid hemorrhage. Neurology 1985, 35: 493-497.

[20] 20. Vermeulen M, van Gijn J. The diagnosis of subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry 1990, 53: 365-372.

[21] 21. Watanbe AT, Mackey JK, Lufkin RB. Imaging diagnosis and temporal appearance of subarachnoid hemorrhage. Neuroimag Clin N Am 1992, 2: 53-59.