Intracranial hypotension in the setting of concurrent perineural cyst rupture and subarachnoid hemorrhage

Update item information
Publication Type pre-print
School or College School of Medicine
Department Neurosurgery
Creator Couldwell, William T.
Other Author Sivakumar, Walavan; Ravindra, Vijay M.; Cutler, Aaron
Title Intracranial hypotension in the setting of concurrent perineural cyst rupture and subarachnoid hemorrhage
Date 2013-01-01
Description Although most patients with intracranial hypotension typically present with headaches, the rest of the clinical spectrum is characteristically non-specific and often quite variable. In a patient with concurrent pathologies that can produce a similar clinical picture, a high index of suspicion must be maintained to garner the correct diagnosis. The authors report a case of intracranial hypotension in the setting of concurrent perineural cyst rupture and subarachnoid hemorrhage. A 63-year-old woman with a family history of ruptured intracranial aneurysms presented after a sudden thunderclap headache and was found to have diffuse subarachnoid hemorrhage. Imaging revealed anterior communicating and superior hypophyseal artery aneurysms. Following the uneventful clipping of both aneurysms, the patient experienced a delayed return to her neurological baseline. After it was noted that the patient had an improved neurological examination when she was placed supine, further workup confirmed intracranial hypotension from perineural cyst rupture. The patient improved and returned to her neurological baseline after undergoing a high-volume blood patch and remained neurologically intact at postoperative follow-up. Although intracranial hypotension is known to be commonly associated with cerebrospinal fluid leak, its causal and temporal relationship with subarachnoid hemorrhage has yet to be elucidated.
Type Text
Publisher Elsevier
Language eng
Bibliographic Citation Sivakumar, W., Ravindra, V. M., Cutler, A., & Couldwell, W. T. (2013). Intracranial hypotension in the setting of concurrent perineural cyst rupture and subarachnoid hemorrhage. Journal of Clinical Neuroscience.
Rights Management (c) Elsevier ; Authors manuscript from Sivakumar, W., Ravindra, V. M., Cutler, A., & Couldwell, W. T. (2013). Intracranial hypotension in the setting of concurrent perineural cyst rupture and subarachnoid hemorrhage. Journal of Clinical Neuroscience. http://dx.doi.org/10.1016/j.jocn.2013.10.011
Format Medium application/pdf
Format Extent 891,948 bytes
Identifier uspace,18372
ARK ark:/87278/s67119fz
Setname ir_uspace
Date Created 2014-03-03
Date Modified 2014-03-03
ID 711531
Reference URL https://collections.lib.utah.edu/ark:/87278/s67119fz