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Cerebral vasospasm associated with intraventricular hemorrhage

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Abstract

Background and Purpose: Cerebral vasospasm remains a major complication associated with aneurysmal subarachnoid hemorrhage. Although several case reports have demonstrated that intraventricular hemorrhage (IVH) related to a ruptured arteriovenous malformation can result in vasospasm in the absence of subarachnoid hemorrhage, to our knowledge, this is the first case report of cerebral vasospasm associated with primary IVH.

Case Report: A 44-year-old female was admitted with cerebellar infarction secondary to left posteroinferior cerebellar artery occlusion. Her hospital stay was complicated by primary IVH. Three days after her IVH, she became disoriented and developed a peculiar interest in counting numbers. This behavioral change was associated with an increase in cerebral blood flow velocity in the anterior circulation. Middle cerebral artery M1 velocity almost doubled from 65 to 130 cm/second. Her symptoms resolved with initiation of hypervolemia, hypertension, and hemodilution (triple H) therapy.

Conclusions: Cerebral vasospasm may contribute to the comorbidities of IVH. Routine transcranial Doppler may be warranted for screening of cerebral vasospasm in IVH patients.

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References

  1. Allen GS, Ahn HS, Preziosi TJ, et al. Cerebral arterial spasm—a controlled trial of nimodipine in patients with subarachnoid hemorrhage. N Engl J Med 1983;308:619–624.

    Article  PubMed  CAS  Google Scholar 

  2. Zubkov AY, Pilkington AS, Bernanke DH, Parent AD, Zhang J. Posttraumatic cerebral vasospasm: clinical and morphological presentations. J Neurotrauma 1999;16:763–770.

    Article  PubMed  CAS  Google Scholar 

  3. Wilkins RH. Hypothalamic dysfunction and intracranial arterial spasms. Surg Neurol 1975;4:472–480.

    PubMed  CAS  Google Scholar 

  4. Dietrich HH, Dacey RG, Jr. Molecular keys to the problems of cerebral vasospasm. Neurosurgery 2000;46:517–530.

    Article  PubMed  CAS  Google Scholar 

  5. Kobayashi M, Takayama H, Mihara B, Kawase T. Severe vasospasm caused by repeated intraventricular haemorrhage from small arteriovenous malformation. Acta Neurochir (Wien) 2002;144:405–406.

    Article  CAS  Google Scholar 

  6. Maeda K, Kurita H, Nakamura T, et al. Occurrence of severe vasospasm following intraventricular hemorrhage from an arteriovenous malformation. Report of two cases. J Neurosurg 1997;87:436–439.

    PubMed  CAS  Google Scholar 

  7. Kothbauer K, Schroth G, Seiler RW, Do DD. Severe symptomatic vasospasm after rupture of an arteriovenous malformation. AJNR Am J Neuroradiol 1995;16:1073–1075.

    PubMed  CAS  Google Scholar 

  8. Claassen J, Bernardini GL, Kreiter K, et al. Effect of cisternal and ventricular blood on risk of delayed cerebral ischemia after subarachnoid hemorrhage: the Fisher scale revisited. Stroke 2001; 32: 2012–2020.

    PubMed  CAS  Google Scholar 

  9. Passero S, Ulivelli M, Reale F. Primary intraventricular haemorrhage in adults. Acta Neurol Scand 2002;105:115–119.

    Article  PubMed  CAS  Google Scholar 

  10. White RP, Hagen AA, Morgan H, Dawson WN, Robertson JT. Experimental study on the genesis of cerebral vasospasm. Stroke 1975;6:52–57.

    PubMed  CAS  Google Scholar 

  11. Liszczak TM, Varsos VG, Black PM, Kistler JP, Zervas NT. Cerebral arterial constriction after experimental subarachnoid hemorrhage is associated with blood components within the arterial wall. J Neurosurg 1983;58:18–26.

    PubMed  CAS  Google Scholar 

  12. Miyagami M, Murakami T, Wakamuatsu K, et al. Experimental and clinical studies on prognosis deteriorating factors in the acute stage of intraventricular hemorrhage. Neurol Med Chir (Tokyo) 1981;21:75–83.

    Article  CAS  Google Scholar 

  13. Pang D, Sclabassi RJ, Horton JA. Lysis of intraventricular blood clot with urokinase in a canine model: Part 3. Effects of intraventricular urokinase on clot lysis and posthemorrhagic hydrocephalus. Neurosurgery 1986;19:553–72.

    Article  PubMed  CAS  Google Scholar 

  14. Svendgaard NA, Arbab MA, Delgado TJ, Rosengren E. Effect of selective lesions of medullary catecholamine nuclei on experimental cerebral vasospasm in the rat. J Cereb Blood Flow Metab 1987;7:21–28.

    PubMed  CAS  Google Scholar 

  15. Black PM. Hydrocephalus and vasospasm after subarachnoid hemorrhage from ruptured intracranial aneurysms. Neurosurgery 1986;18:12–16.

    Article  PubMed  CAS  Google Scholar 

  16. Fisher CM, Kistler JP, Davis JM. Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning. Neurosurgery 1980;6:1–9.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Michel T. Torbey.

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Dull, C., Torbey, M.T. Cerebral vasospasm associated with intraventricular hemorrhage. Neurocrit Care 3, 150–152 (2005). https://doi.org/10.1385/NCC:3:2:150

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