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KMID : 1001920080430030162
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Journal of Korean Neurosurgical Society
2008 Volume.43 No. 3 p.162 ~ p.164
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Contralateral Intraparenchymal Hemorrhage Following Aneurysmal Clipping
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Kim Jae-Hoon
Yi Hyeong-Joong
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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.
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KEYWORD
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Border-zone, Cerebral aneurysm, Hyperdynamic therapy, Intraparenchymal hemorrhage (Intra-arterial), Nimodipine injection, Vasospasm
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