Fluss Rose, Laarakker Avra, Nakhla Jonathan, Brook Allan, Altschul David Joseph
Department of Neurosurgery, Montefiore Medical Center, University Hospital for Albert Einstein College of Medicine, Bronx, NY, USA.
Department of Plastics Surgery, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, USA.
Surg Neurol Int. 2019 Mar 11;10:29. doi: 10.4103/sni.sni_396_18. eCollection 2019.
Though still thought to be rare, in recent years, vasospasm as a result of primary intraventricular hemorrhage (IVH) has been increasingly recognized in patients with spontaneous primary intraventricular hemorrhage, of various etiologies. Unlike vasospasm in aneurysmal subarachnoid hemorrhage (SAH), which has a well-defined time frame of 3-21 days, such a window is poorly defined for primary spontaneous intraventricular hemorrhage from other vascular etiologies.
We report on two cases of prolonged delayed proximal intracranial cerebral vasospasm occurring 29 and 22 days after the initial presentation.
To our knowledge, this is the first report of such delayed vasospasm in spontaneous primary intraventricular hemorrhage secondary to a dural arteriovenous fistula and cavernous malformation. Our two cases of vasospasm in patients with nontraumatic nonaneurysmal SAH with IVH presented outside the expected time period of 21 days. It is important to recognize that symptomatic vasospasm secondary to intraventricular hemorrhage is a rare but devastating complication that can have serious deleterious consequences if gone unrecognized and untreated.
尽管仍被认为较为罕见，但近年来，各种病因的自发性原发性脑室内出血患者中，因原发性脑室内出血（IVH）导致的血管痉挛越来越受到关注。与动脉瘤性蛛网膜下腔出血（SAH）的血管痉挛不同，后者有明确的3 - 21天时间窗，而其他血管病因导致的原发性自发性脑室内出血的这一窗口定义并不明确。
我们报告两例初始发病后29天和22天出现的持续性延迟性近端颅内脑血管痉挛病例。
据我们所知，这是首例关于硬脑膜动静脉瘘和海绵状畸形继发的自发性原发性脑室内出血中这种延迟性血管痉挛的报告。我们两例非创伤性非动脉瘤性SAH合并IVH患者的血管痉挛发生在预期的21天时间窗之外。必须认识到，脑室内出血继发的症状性血管痉挛是一种罕见但具有毁灭性的并发症，如果未被识别和治疗，可能会产生严重的有害后果。
