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Fulltext Clinical utility of 64-row multislice CT angiography in the detection of cerebral aneurysms in acute subarachnoid haemorrhage

Chang LK, Liew NS, Soh HL, Tan SZ, Wong SH

Med J Malaysia, 2008 Jun;63(2):131-6.
PMID: 18942299 MyJurnal

CT angiography (CTA) is a fast examination performed with a time-optimised contrast injection to enhance the cerebral arteries. Being a new imaging modality in our hospital, evaluation of the effectiveness of 64-row multislice CTA in detecting intracranial aneurysms in ruptured subarachnoid haemorrhage (SAH) cases is necessary. We conducted a descriptive prospective study by recruiting 30 consecutively operated SAH cases from May 2005 until November 2006. CTA findings were studied by radiologist and neurosurgeon and these were compared with operative findings. The sensitivity and specificity of CTA were 94.4% and 97.2% respectively. Approximately half of the patients were scanned within four hours and operated within 24 hours. In conclusion, CTA proves to be highly sensitive and specific in the diagnosis of intracranial aneurysms in our study.
KEY WORDS: Subarachnoid haemorrhage, Intracranial aneurysm, Computed tomography (CT), CT angiography (CTA), Sarawak

Matched MeSH terms: Subarachnoid Hemorrhage/complications*
Bilateral internal carotid artery occlusions a cause of transient ischemic attack

Zulkifli A

Med J Malaysia, 1979 Sep;34(1):52-4.
PMID: 542153
Matched MeSH terms: Subarachnoid Hemorrhage/complications
Fulltext QTc Interval Prolongation and Hemorrhagic Stroke: Any Difference Between Acute Spontaneous Intracerebral Hemorrhage and Acute Non-traumatic Subarachnoid Hemorrhage?

Amin OSM, Al-Bajalan SJ, Mubarak A

Med Arch, 2017 Jun;71(3):193-197.
PMID: 28974832 DOI: 10.5455/medarh.2017.71.193-197

BACKGROUND: A variety of ECG changes occur as an aftermath of stroke. Prolongation of the QTc interval is a well-documented change. We analyzed QTc interval prolongation among patients with acute hemorrhagic strokes.
METHODS: This observational study was conducted at the Emergency Department of Sulaymaniyah General Teaching Hospital and Shar Hospital from September 1st, 2014 to August 31st, 2015. Fifty patients who developed acute spontaneous hypertensive intracerebral hemorrhage (ICH) and 50 patients who developed acute non-traumatic subarachnoid hemorrhage (SAH) were included in the study. All patients underwent resting 12-lead ECG within half an hour of admission. The QTc interval was calculated and analyzed in those 100 patients.
RESULTS: Females (62%) outnumbered males (38%) with a female to male ratio of 1.6:1. Forty percent of the patients were between 60-69 years of age. Hypertension was seen in 82% of patients while left ventricular hypertrophy was documented in 40% of patients. The QTc was prolonged in 38 patients (17 patients in the ICH group and 21 patients in the SAH group). In both groups, males demonstrated QTc prolongation more than females. However, there were no statistically significant gender difference between both groups and within the same group. There was a statistically significant association between SAH and QTc prolongation (p-value<0.001); the ICH group did not demonstrate any significant relationship with QTc prolongation.
CONCLUSION: Prolongation in the QTc interval was "statistically" associated with acute SAH only. No gender difference was noted; whether this observation is clinically significant or not, it needs further analytic studies.

Matched MeSH terms: Subarachnoid Hemorrhage/complications*
Fulltext Coma due to malplaced external ventricular drain

Chai FY, Farizal F, Jegan T

Turk Neurosurg, 2013;23(4):561-3.
PMID: 24101284 DOI: 10.5137/1019-5149.JTN.5724-12.1

Ventriculostomy or external ventricular drain (EVD) placement by free-hand technique has a high malplacement rate. It is a blind procedure that often requires multiple attempts and revisions. To date, no neurological complication due to EVD malplacement has been reported in the literature. In this report, we present the first case of coma induced by a malplaced EVD and the patient regained consciousness after the drain was adjusted. Our discussion focused on various techniques that can improve the accuracy of EVD insertion. EVD insertion under image guidance provides better accuracy with limited disadvantages. We hypothesized that the patient's coma was due to the mass effect and irritation of the malplaced EVD exerted onto the ventral periaqueductal grey matter and the ascending neurons from upper brainstem.

Matched MeSH terms: Subarachnoid Hemorrhage/complications