Articles: subarachnoid-hemorrhage.
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CT scans have been made on 39 of 41 patients who presented with subarachnoid hemorrhage. Blood could be visualized in the cisterns of 18 of 32 examinations performed within five days of the hemorrhage all having aneurysms. ⋯ Much other information was obtained, for instance about rebleeding and infarction. CT should routinely be the primary examination, followed by selective angiography.
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Post-shunt subdural hematoma was found in two patients with hydrocephalus due to subarachnoid hemorrhage. The first case was a 46-year-old man with two episodes of subarachnoid hemorrhage from anterior communicating aneurysm. Two weeks after neck-clipping for the aneurysm, a ventriculo-peritoneal shunt with Pudenz's system was performed since hydrocephalus with moderately increased pressure had been found. ⋯ After cerebral angiogram, the subdural hematoma was removed and the shunt tube was ligated. He became free of these symptoms in two weeks. The cerebrospinal fluid shunt is recommended for hydrocephalus induced by subarachnoid hemorrhage, but careful follow-up is necessary since these patients might develop post-shunt subdural hematoma, especially after head trauma as shown in our cases.
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Zh Nevropatol Psikhiatr Im S S Korsakova · Jan 1977
[Changes in cardiac activity in the acute period of subarachnoid hemorrhage].
In the acute phase of subarachnoidal hemorrhages which was seen in 32 patients the author studied changes in the cardiac activity and phasic structures of cardiac contraction. The studies were supplemented by electrocardiographic and polycardiographic methods permitting to determined separate phases of cardiac contraction and quantitatively characterize the contracting function of the myocardium. In 21 patients according to the EGC data there were changes in the cardiac activity. It is assumed that the main role in the development of such changes during subarachnoidal hemorrhages belongs to diencephalic brain structures, the changed function of which lead to distrubances of central regulation of the heart activity.
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Clinical use of four-vessels angiography increased the frequency of detection of intracranial aneurysm in patients who had episode of subarachnoid hemorrhage. However, some cases of subarachnoid hemorrhage did not show intracranial and intraspinal source of bleeding angiographically. Bjökesten and Troupp pointed out that some cases who were negative in angiography may have a very small intracranial aneurysm. ⋯ In the case who showed questionable shadow as miliary intracranial aneurysm, the repeated angiography under modified direction of X-ray and modified head position of patient is required. The magnification cerebral angiography of three fold is also useful in diagnosis of miliary intracranial aneurysm. The intracranial treatment of miliary intracranial aneurysms were done by coating except one case whose aneurysm was clipped.