J Korean Neurosurg Soc.  2008 Mar;43(3):162-164. 10.3340/jkns.2008.43.3.162.

Contralateral Intraparenchymal Hemorrhage Following Aneurysmal Clipping

• Kim JH
• Yi HJ

• KMID: 2067325
• DOI: http://doi.org/10.3340/jkns.2008.43.3.162

Abstract

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.

Keyword

Border-zone; Cerebral aneurysm; Hyperdynamic therapy; Intraparenchymal hemorrhage (Intra-arterial) Nimodipine injection; Vasospasm

MeSH Terms

Aneurysm
Aneurysm, Ruptured
Hemodynamics
Hemorrhage
Humans
Intracranial Aneurysm
Middle Aged
Nimodipine
Subarachnoid Hemorrhage
Unconscious (Psychology)
Nimodipine