Focal laminar cortical MR signal abnormalities after subarachnoid hemorrhage

In the autopsy studies of patients with delayed ischemic neurological deficits after subarachnoid hemorrhage, a predominance of cortical lesions has been observed. Similar to the autopsy descriptions in the literature, we present magnetic resonance images visualizing focal laminar cortical lesions around a fissure or sulcus in two patients, who initially did not undergo surgery, with delayed ischemic neurological deficits. This magnetic resonance imaging pattern may provide a clue to the diagnosis if the patient does not present to the emergency room with the acute hemorrhage but with delayed ischemic neurological deficits.

[1]  B. Dubois,et al.  Is the Saitohin gene involved in neurodegenerative diseases? , 2002, Annals of neurology.

[2]  U. Lindauer,et al.  Ischaemia triggered by spreading neuronal activation is inhibited by vasodilators in rats , 2001, The Journal of physiology.

[3]  U Dirnagl,et al.  Products of hemolysis in the subarachnoid space inducing spreading ischemia in the cortex and focal necrosis in rats: a model for delayed ischemic neurological deficits after subarachnoid hemorrhage? , 2000, Journal of neurosurgery.

[4]  L. Caplan,et al.  Avoiding pitfalls in the diagnosis of subarachnoid hemorrhage. , 2000, The New England journal of medicine.

[5]  Ulrich Dirnagl,et al.  Nitric Oxide Scavenging by Hemoglobin or Nitric Oxide Synthase Inhibition by N-Nitro-L-Arginine Induces Cortical Spreading Ischemia When K+ Is Increased in the Subarachnoid Space , 1998, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[6]  E. Nussbaum,et al.  Intracranial aneurysm rupture presenting as delayed stroke secondary to cerebral vasospasm. , 1997, Stroke.

[7]  J. Cervós-Navarro,et al.  Stroke and microcirculation , 1987 .

[8]  M. Crompton CEREBRAL INFARCTION FOLLOWING THE RUPTURE OF CEREBRAL BERRY ANEURYSMS , 1964 .

[9]  M. I. Tom,et al.  Incidence of cerebral infarction associated with ruptured intracranial aneurysms , 1960, Neurology.

[10]  Falconer Ma Surgical pathology of spontaneous intracranial haemorrhage due to aneurysms and arteriovenous malformations. , 1954 .

[11]  M. Falconer Surgical pathology of spontaneous intracranial haemorrhage due to aneurysms and arteriovenous malformations. , 1954, Proceedings of the Royal Society of Medicine.

[12]  E. G. Robertson Cerebral lesions due to intracranial aneurysms. , 1949, Brain : a journal of neurology.