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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(12): 858-861
DOI: 10.1590/0004-282X20170170
Article

Convexity subarachnoid hemorrhage: clinical features and etiology of an Argentinian cohort

Hemorragia subaracnóidea da convexidade: características clínicas e etiologia de uma coorte argentina
Aníbal Chertcoff
1   Hospital Británico de Buenos Aires, Department of Neurology, Perdriel, Buenos Aires, Argentina
,
Lucrecia Bandeo
1   Hospital Británico de Buenos Aires, Department of Neurology, Perdriel, Buenos Aires, Argentina
,
Fátima Pantiu
1   Hospital Británico de Buenos Aires, Department of Neurology, Perdriel, Buenos Aires, Argentina
,
Luciana León Cejas
1   Hospital Británico de Buenos Aires, Department of Neurology, Perdriel, Buenos Aires, Argentina
,
Sol Pacha
1   Hospital Británico de Buenos Aires, Department of Neurology, Perdriel, Buenos Aires, Argentina
,
Claudia Uribe Roca
1   Hospital Británico de Buenos Aires, Department of Neurology, Perdriel, Buenos Aires, Argentina
,
Manuel Fernández Pardal
1   Hospital Británico de Buenos Aires, Department of Neurology, Perdriel, Buenos Aires, Argentina
,
Ricardo Reisin
1   Hospital Británico de Buenos Aires, Department of Neurology, Perdriel, Buenos Aires, Argentina
,
Pablo Bonardo
1   Hospital Británico de Buenos Aires, Department of Neurology, Perdriel, Buenos Aires, Argentina
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ABSTRACT

Nontraumatic convexity subarachnoid hemorrhage is an increasingly recognized subtype of subarachnoid bleeding.

Objective: Our aim was to describe the etiology and clinical features of a cohort of patients with convexity subarachnoid hemorrhage.

Methods: We retrospectively analyzed all cases of convexity subarachnoid hemorrhage admitted to our hospital between January 2012 and April 2017. Demographic features, clinical characteristics, complementary investigations, etiology and mortality were assessed. Twenty patients (65% females) were identified. Mean age: 53 years (range, 15-86 years).

Results: Symptoms on admission: headache (65%), sensory and/or motor symptoms (50%) and seizures (35%). Commonest causes: cerebral vein thrombosis (20%), reversible cerebral vasoconstriction syndrome (20%) and cerebral amyloid angiopathy (20%). Two patients died.

Conclusion: Convexity subarachnoid hemorrhage may be related to a wide spectrum of etiologies. In our patients, an increased prevalence of cerebral vein thrombosis was observed. Mortality was low and not related to the bleeding itself.

RESUMO

A hemorragia subaracnóidea não traumática da convexidade é um subtipo cada vez mais reconhecido de sangramento subaracnóideo.

Objetivo: Nosso objetivo foi descrever a etiologia e as características clínicas de uma coorte de pacientes com hemorragia subaracnóidea da convexidade.

Métodos: Foram analisados retrospectivamente todos os casos de hemorragia subaracnóidea da convexidade admitidos em nosso hospital entre janeiro de 2012 e abril de 2017. Foram avaliados os aspectos demográficos, características clínicas, investigações complementares, etiologia e mortalidade. Vinte pacientes (65% mulheres) foram identificados. Média de idade: 53 anos (intervalo, 15-86).

Resultados: Sintomas na admissão: dor de cabeça (65%), sintomas sensitivos e/ou motores (50%) e convulsões (35%). Causas mais comuns: trombose venosa cerebral (20%), síndrome de vasoconstrição cerebral reversível (20%) e angiopatia amilóide cerebral (20%). Dois pacientes morreram.

Conclusão: A hemorragia subaracnóidea da convexidade pode estar relacionada a um amplo espectro de etiologias. Em nossos pacientes, observou-se uma maior prevalência de trombose venosa cerebral. A mortalidade foi baixa e não relacionada à própria hemorragia.

Keywords:

cerebral amyloid angiopathy - etiology - sinus thrombosis - intracranial - subarachnoid hemorrhage

Palavras-chave:

angiopatia amiloide cerebral - etiologia - trombose dos seios intracranianos - hemorragia subaracnóidea


Publication History

Received: 07 May 2017

Accepted: 25 September 2017

Article published online:
01 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Kumar S, Goddeau RP Jr, Selim MH, Thomas A, Schlaug G, Alhazzani A et al. Atraumatic convexal subarachnoid hemorrhage: clinical presentation, imaging patterns, and etiologies. Neurology. 2010;16;74(11):893-9. https://doi.org/10.1212/WNL.0b013e3181d55efa
  • 2 Bruno VA, Lereis VP, Hawkes M, Ameriso SF. Nontraumatic subarachnoid hemorrhage of the convexity. Curr Neurol Neurosci Rep. 2013;13(4):338. https://doi.org/10.1007/s11910-013-0338-3
  • 3 Knudsen KA, Rosand J, Karluk D, Greenberg SM. Clinical diagnosis of cerebral amyloid angiopathy: validation of the Boston criteria. Neurology 2001;56(4):537-9. https://doi.org/10.1212/WNL.56.4.537
  • 4 Rooden S, Grond J, Boom R, Haan J, Linn J, Greenberg SM et al. Descriptive analysis of the Boston criteria applied to a Dutch-type cerebral amyloid angiopathy population. Stroke 2009;40(9):3022-7. https://doi.org/10.1161/STROKEAHA.109.554378
  • 5 Ducros A. Reversible cerebral vasoconstriction syndrome. Lancet Neurol 2012; 11(10): 906-17. https://doi.org/10.1016/S1474-4422(12)70135-7
  • 6 Graff-Radford J, Fugate JE, Klaas J, Flemming KD, Brown RD, Rabinstein AA. Distinguishing clinical and radiological features of non-traumatic convexal subarachnoid hemorrhage. Eur J Neurol. 2016;23(5):839-46. https://doi.org/10.1111/ene.12926
  • 7 Beitzke M, Gattringer T, Enzinger C, Wagner G, Niederkorn K, Fazekas F. Clinical presentation, etiology, and long-term prognosis in patients with nontraumatic convexal subarachnoid hemorrhage. Stroke. 2011;42(11):3055-60. https://doi.org/10.1161/STROKEAHA.111.621847
  • 8 Bittencourt LK, Palma-Filho F, Domingues RC, Gasparetto EL. Subarachnoid hemorrhage in isolated cortical vein thrombosis: are presentation of an unusual condition. Arq Neuropsiquiatr. 2009;67(4):1106-8. https://doi.org/10.1590/S0004-282X2009000600029
  • 9 Benabu Y, Mark L, Daniel S, Glikstein R. Cerebral venous thrombosis presenting with subarachnoid hemorrhage: case report and review. Am J Emerg Med. 2009;27(1):96-106. https://doi.org/10.1016/j.ajem.2008.01.021
  • 10 Saposnik G, Barinagarrementeria F, Brown RD Jr, Bushnell CD, Cucchiara B, Cushman M et al. Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(4):1158-92. https://doi.org/10.1161/STR.0b013e31820a8364
  • 11 Charidimou A, Linn J, Vernooij MW, Opherk C, Akoudad S, Baron JC et al. Cortical superficial siderosis: detection and clinical significance in cerebral amyloid angiopathy and related conditions. Brain. 2015;138(Pt 8):2126-39. https://doi.org/10.1093/brain/awv162
  • 12 Patel KC, Finelli PF. Nonaneurysmal convexity subarachnoid hemorrhage. Neurocrit Care. 2006;4(3):229-33. https://doi.org/10.1385/NCC:4:3:229
  • 13 Nayak S, Kunz AB, Kieslinger K, Ladurner G, Killer M. Classification of non-aneurysmal subarachnoid haemorrhage: CT correlation to the clinical outcome. Neuroradiol J. 2011;24(5):715-25. https://doi.org/10.1177/197140091102400508