ABSTRACT
Subarachnoid hemorrhage constitutes approximately 10% of cases of cerebrovascular disease and its incidence ranges between 11 and 28 cases/100,000/year. More than 80% of cases are secondary to rupture of cerebral aneurysm; however, in 5 to 16% of patients with subarachnoid hemorrhage it is not possible to find a cause (subarachnoid hemorrhage with negative angiography). This group of patients represents a dilemma for the correct diagnosis, treatment and prognosis; there is no consensus on the criteria to repeat the angiography after the first negative study. The results of our study includes 14 patients with subarachnoid hemorrhage and negative angiography. The angiographic study was repeated two or more times. Our observations suggest that the overall prognosis for these patients is very good (86%). The risk of another hemorrhage after discharge from the hospital is small. Our results are compared with those in other published series.
Subject(s)
Cerebral Angiography , Subarachnoid Hemorrhage/diagnostic imaging , Adolescent , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Prognosis , Subarachnoid Hemorrhage/diagnosis , Time Factors , Tomography, X-Ray ComputedABSTRACT
Reported are 15 cases of children who suffered injuries to their posterior fossa and the subsequent formation of hematomas and their treatment by the physicians in the Neurosurgical Department of the Traumatology Hospital "Magdalena de las Salinas". Of the 15 cases, 11 had epidural hematomas (three of them with supratentorial extensions), one was subdural, two were cerebellar and another of the brainstem. Seven were considered acute, five were subacute and three were chronic. During their admittance to the hospital, five of the patients were in a state of coma, another five were sleepy or confused and the remaining five were conscious. Three of the patients were conservatively treated, two of which had sequelae or were moderately handicapped. Twelve of the patients were surgically intervened suboccipitally, eleven of which successfully recovered and one of which died. A history of brain injury, occipital fracture and signs of posterior fossa lesions lead to suspect the presence of posterior fossa hematoma.
