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Underlying Venous Pathology Causing Perimesencephalic Subarachnoid Hemorrhage

Published online by Cambridge University Press:  02 December 2014

Jaejoon Lee ,
Eun-Mi Koh ,
Chin-Sang Chung ,
Seung-Chul Hong ,
Yong-Bum Kim ,
Pil-Wook Chung ,
Bum-Chun Suh  and
Heui-Soo Moon
Jaejoon Lee
Affiliation:
Department of Medicine, Samsung Medical Centre
Eun-Mi Koh
Affiliation:
Department of Medicine, Samsung Medical Centre
Chin-Sang Chung
Affiliation:
Department of Neurology, Samsung Medical Centre
Seung-Chul Hong
Affiliation:
Department of Neurosurgery, Samsung Medical Centre
Yong-Bum Kim
Affiliation:
Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Pil-Wook Chung
Affiliation:
Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Bum-Chun Suh
Affiliation:
Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Heui-Soo Moon*
Affiliation:
Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
*
Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Abstract

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Background:

Perimesencephalic subarachnoid hemorrhage (PSH) is a relatively benign clinical entity with a low risk of recurrent bleeding. The precise etiology of PSH has not yet been determined. We report here three cases of PSH with clinical and radiological features that support a venous system as a cause.

Case Presentation:

The first patient, a 72-year-old woman, had PSH and venous hemorrhagic infarct in the left thalamus on non-contrast CT. Subsequent cerebral angiography revealed widespread thrombosis in the cerebral venous system, a potential cause for reflux overflow hemorrhage. The second patient, a 55-year-old man with an established diagnosis of neuro-Behçet's disease, a well-known cause for cerebral venulitis, presented with PSH one year later. The third patient, a 39-year-old female, with incomplete Behçet's disease was admitted with PSH.

Discussion:

Current concepts on the anatomic origin and the possible pathophysiologic mechanism leading to PSH are discussed. The underlying pathological conditions in the venous system in our cases provide theoretical clues to the anatomic origin of PSH in general.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 36 , Issue 5 , September 2009 , pp. 638 - 642
Copyright
Copyright © The Canadian Journal of Neurological 2009

References

1.Marquardt, G, Niebauer, T, Schick, U, Lorenz, R.Long term follow up after perimesencephalic subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry. 2000;69(1):127–30.Google Scholar
2.Bradac, GB, Bergui, M, Ferrio, MF, Fontanella, M, Stura, G.Falsenegative angiograms in subarachnoid haemorrhage due to intracranial aneurysms. Neuroradiology. 1997;39(11):772–6.CrossRefGoogle ScholarPubMed
3.Schwartz, TH, Solomon, RA.Perimesencephalic nonaneurysmal subarachnoid hemorrhage: review of the literature. Neurosurgery. 1996;39(3):433–40; discussion 40.Google Scholar
4.Rinkel, GJ, Wijdicks, EF, Hasan, D, Kienstra, GE, Franke, CL, Hageman, LM, et al.Outcome in patients with subarachnoid haemorrhage and negative angiography according to pattern of haemorrhage on computed tomography. Lancet. 1991;338(8773):964–8.Google Scholar
5.van Gijn, J, van Dongen, KJ, Vermeulen, M, Hijdra, A.Perimesencephalic hemorrhage: a nonaneurysmal and benign form of subarachnoid hemorrhage. Neurology. 1985;35(4):493–7.CrossRefGoogle ScholarPubMed
6.Rinkel, GJ, Wijdicks, EF, Vermeulen, M, Hasan, D, Brouwers, PJ, van Gijn, J.The clinical course of perimesencephalic nonaneurysmal subarachnoid hemorrhage. Ann Neurol. 1991;29(5):463–8.Google Scholar
7.Schwartz, TH, Mayer, SA.Quadrigeminal variant of perimesencephalic nonaneurysmal subarachnoid hemorrhage. Neurosurgery. 2000;46(3):584–8.Google Scholar
8.Rinkel, GJ, Wijdicks, EF, Vermeulen, M, Ramos, LM, Tanghe, HL, Hasan, D, et al.Nonaneurysmal perimesencephalic subarachnoid hemorrhage: CT and MR patterns that differ from aneurysmal rupture. AJNR Am J Neuroradiol. 1991;12(5):829–34.Google Scholar
9.van der Schaaf, IC, Velthuis, BK, Gouw, A, Rinkel, GJ.Venous drainage in perimesencephalic hemorrhage. Stroke. 2004;35(7):1614–8.Google Scholar
10.Watanabe, A, Hirano, K, Kamada, M, Imamura, K, Ishii, N, Sekihara, Y, et al.Perimesencephalic nonaneurysmal subarachnoid haemorrhage and variations in the veins. Neuroradiology. 2002;44(4):319–25.CrossRefGoogle ScholarPubMed
11.Yamakawa, H, Ohe, N, Yano, H, Yoshimura, S, Iwama, T.Venous drainage patterns in perimesencephalic nonaneurysmal subarachnoid hemorrhage. Clin Neurol Neurosurg. 2008;110(6):587–91.Google Scholar
12.Daenekindt, T, Wilms, G, Thijs, V, Demaerel, P, Van Calenbergh, F.Variants of the basal vein of Rosenthal and perimesencephalic nonaneurysmal hemorrhage. Surg Neurol. 2008;69(5):526–9; discussion 9.CrossRefGoogle ScholarPubMed
13.Matsumaru, Y, Yanaka, K, Muroi, A, Sato, H, Kamezaki, T, Nose, T.Significance of a small bulge on the basilar artery in patients with perimesencephalic nonaneurysmal subarachnoid hemorrhage. Report of two cases. J Neurosurg. 2003;98(2):426–9.Google Scholar
14.Lansberg, MG.Concurrent presentation of perimesencephalic subarachnoid hemorrhage and ischemic stroke. J Stroke Cerebrovasc Dis. 2008;17(4):248–50.CrossRefGoogle ScholarPubMed
15.Sztajzel, R, Coeytaux, A, Dehdashti, AR, Delavelle, J, Sinnreich, M.Subarachnoid hemorrhage: a rare presentation of cerebral venous thrombosis. Headache. 2001;41(9):889–92.Google Scholar
16.Capra, NF, Anderson, KV.Anatomy of the cerebral venous system. In: Kapp, JP, Schmidek, HH, editors. The cerebral venous system and its disorders. Orlando, FL: Grune & Stratton; 1984. p. 1–36.Google Scholar
17.Ameri, A, Bousser, MG.Cerebral venous thrombosis. Neurol Clin. 1992;10(1):87–111.CrossRefGoogle ScholarPubMed
18.International Study Group for Behçet’s Disease. Criteria for diagnosis of Behçet’s disease. Lancet. 1990;335(8697):1078–80.Google Scholar
19.Akman-Demir, G, Serdaroglu, P, Tasci, B.Clinical patterns of neurological involvement in Behcet’s disease: evaluation of 200 patients. The Neuro-Behçet’s Study Group. Brain. 1999;122 (Pt 11):2171–82.Google Scholar
20.Banna, M, el-Ramahl, K.Neurologic involvement in Behcet disease: imaging findings in 16 patients. AJNR Am J Neuroradiol. 1991;12(4):791–6.Google ScholarPubMed
21.Kocer, N, Islak, C, Siva, A, Saip, S, Akman, C, Kantarci, O, et al.CNS involvement in neuro-Behçet’s syndrome: an MR study. AJNR Am J Neuroradiol. 1999;20(6):1015–24.Google Scholar
22.Kidd, D, Steuer, A, Denman, AM, Rudge, P.Neurological complications in Behçet’s syndrome. Brain. 1999;122 (Pt 11): 2183–94.Google Scholar
23.Mizushima, Y.Recent research into Behçet’s disease in Japan. Int J Tissue React. 1988;10(2):59–65.Google Scholar
24.Kurosu, A, Suzukawa, K, Amo, M, Horinaka, N, Arai, H.Perimesencephalic non-aneurysmal subarachnoid hemorrhage caused by cavernous sinus thrombosis: case report. Neurol Med Chir (Tokyo). 2007;47(6):258–60.CrossRefGoogle ScholarPubMed
25.Sangra, MS, Teasdale, E, Siddiqui, MA, Lindsay, KW.Perimesencephalic nonaneurysmal subarachnoid hemorrhage caused by jugular venous occlusion: case report. Neurosurgery. 2008;63(6):E1202–3; discussion E3.Google Scholar