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Journal of Korean Neurosurgical Society > Volume 43(3); 2008 > Article
Journal of Korean Neurosurgical Society 2008;43(3): 162-164.
doi: https://doi.org/10.3340/jkns.2008.43.3.162
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
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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