| Contralateral Intraparenchymal Hemorrhage Following Aneurysmal Clipping. |
| Jae Hoon Kim, Hyeong Joong Yi |
1Department of Neurosurgery, Nowon Eulji Hospital, Seoul, Korea.
2Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea. hjyi8499@hanyang.ac.kr |
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| ABSTRACT |
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Post-clipping intraparenchymal hemorrhage of the contralateral hemisphere is a very unusual phenomenon in a patient with aneurysmal subarachnoid hemorrhage, unless there is an underlying condition. We report a complicated case of 47-year-old man, who underwent uneventful clipping of ruptured aneurysm and experienced vasospasm two weeks later. Vasospasm was treated by intra-arterial nimodipine and systemic hyperdynamic therapy. One week thereafter, he became unconscious due to intraparenchymal hemorrhage on the anterior border-zone of contalateral hemisphere, but intraoperative and pathologic findings failed to disclose any vascular anomaly. We suggest that the anti-spastic regimens cause local hemodynamic redistribution through the vasodilatory effect and in turn, resulted in such an unexpected bleeding. |
| Key Words:
Border-zone; Cerebral aneurysm; Hyperdynamic therapy; Intraparenchymal hemorrhage (Intra-arterial) Nimodipine injection; Vasospasm |
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