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Case Reports
. 2017 Apr;22(2):134-137.
doi: 10.17712/nsj.2017.2.20160451.

Basilar artery vasospasm after pretuncal non-aneurysmal subarachnoid hemorrhage responding to milrinone

Abdulrahman Y Alturki  1 , Abdullah S Alamri, Mohamed M Badawy, Benjamin W Lo
Affiliations
Case Reports

Basilar artery vasospasm after pretuncal non-aneurysmal subarachnoid hemorrhage responding to milrinone

Abdulrahman Y Alturki et al. Neurosciences (Riyadh). 2017 Apr.

Abstract

Pretruncal (perimesencephalic) non-aneurysmal subarachnoid hemorrhage (PNSAH) is uniformly associated with an excellent outcome. Although cerebral vasospasm remains a common complication of SAH and constitutes an important predictor of outcome, in the setting of PNSAH, it is extremely rare. Preturnal non-aneurysmal subarac refers to a subset of SAH patients with a characteristic pattern of localized blood on CT of the head, normal cerebral angiography, and benign course when compared to the aneurysmal SAH population. The presence of radiological or even clinical vasospasm does not exclude the diagnosis of PNSAH. To our knowledge, this is the first case of symptomatic cerebral vasospasm due to PNSAH that responded to milrinone.

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Figures

Figure 1
Figure 1
- Head CT demonstrate subarachnoid hemorrhage anterior and lateral to the pons.
Figure 2
Figure 2
- Lateral view CTA 3D reconstruction done at admission.
Figure 3
Figure 3
- Anterior-posterior and lateral views CTA 3D reconstruction shows severe upper mid basilar artery vasospasm.
Figure 4
Figure 4
- Anterior-posterior and lateral views CTA 3D reconstruction shows complete resolution of basilar artery vasospasm in response to milrinone therapy.
See this image and copyright information in PMC

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