Convexal subarachnoid hemorrhage and acute ischemic stroke: a border zone matter? View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-04-02

AUTHORS

Alessandro Introna, Domenico Maria Mezzapesa, Marco Petruzzellis, Mariantonietta Savarese, Luigi Chiumarulo, Domenico Sergio Zimatore, Franca Dicuonzo, Isabella Laura Simone

ABSTRACT

BACKGROUND: Convexal subarachnoid hemorrhage (c-SAH) is an infrequent condition with variable causes. c-SAH concomitant to acute ischemic stroke (AIS) is even less frequent, and the relationship between the two conditions remains unclear. METHODS: Between January 2016 and January 2018, we treated four patients who were referred to our stroke unit with ischemic stroke and concomitant nontraumatic c-SAH. The patients underwent an extensive diagnostic workup, including digital subtraction angiography (DSA). RESULTS: All four patients developed acute focal neurological symptoms with restricted MRI diffusion in congruent areas. In three of the patients, infarcts were in a border zone between the main cerebral arteries and c-SAH was nearby. The fourth patient showed a small cortical infarct, and c-SAH was in a border zone territory of the contralateral hemisphere. An embolic source was discovered or strongly suspected in all cases. One patient was treated with intravenous thrombolysis, but this treatment was not related to c-SAH. None of the four patients showed microbleeds or further cortical siderosis, thus excluding cerebral amyloid angiopathy. In addition, DSA did not show signs of vasculitis, reversible cerebral vasoconstriction syndrome, or intracranial arterial dissection. CONCLUSIONS: We proposed the embolism or hemodynamic changes of the border zone arterioles as a unifying pathogenetic hypothesis of coexisting c-SAH and AIS. More... »

PAGES

1-6

Journal

TITLE

Neurological Sciences

ISSUE

N/A

VOLUME

N/A

Author Affiliations

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10072-019-03868-6

DOI

http://dx.doi.org/10.1007/s10072-019-03868-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1113172422

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30937557


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