Subarachnoid Haemorrhage - download pdf or read online

By R. P. Sengupta MSc, FRCS, FRCS(Ed), V. L. McAllister DMRD, FRCR (auth.)

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Extra resources for Subarachnoid Haemorrhage

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At angiography th ey are best demonstrated on the AP projections, especially with magnification (See Figs. 14). 6) but they are usually obscured by the middle cerebral branches. Those in the medial group are very small, and may not be identified even with magnification studies. The lateral group usually consists of six to eight vessels which are typically elearly seen (Fig. 14). Identiftcation and protection of the lenticulostriate arteries at surgery is of extreme importance, especially when aneurysms arise at the junction of the middle cerebral artery and the lenticulostriate arteries.

Evidence of previous minor haemorrhage in an aneurysm wall is a common finding in pathological studies and can be due to blood extravasated from the vasa vasorum passing through fenestrations in the elastic layer (Nystrom 1963). Blood elots within the sae of a large aneurysm are also a common finding, and reftect circulatory disturbances in the aneurysm itself. Such blood elots may occasionally be demonstrated on eT sean. eA sudden leak into the wall of an aneurysm may give rise to the elinical features of a diffuse SAH, but without significant blood in the cerebrospinal ftuid, a point of elinical importance since it can be falsely eoneluded that SAH has not been responsible for the patient's headaches.

12. Anterior cerebral artery variations (after Alpers) Alpers et al. (1959) examined 350 normal adult brains, and showed anomalies of the anterior cerebral artery in 43 cases (12%) (Fig. 12). The abnormalities were predominantly in accessory vesseIs, sueh as a triple anterior cerebral artery in 28 cases. In six cases there was fusion of both anterior cerebral arteries to form a single vessel (azygous anterior cerebral artery) for a variable distance. A hypoplastic anterior cerebral artery was present only in eight cases (2%).

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