Basilar artery vasospasm after pretuncal non-aneurysmal subarachnoid hemorrhage responding to milrinone

• Published in: Neurosciences (Riyadh, Saudi Arabia) Vol. 22; no. 2; pp. 134 - 137
• Main Authors: Alturki, Abdulrahman Y, Alamri, Abdullah S, Badawy, Mohamed M, Lo, Benjamin W
• Format: Journal Article
• Language: English
• Published: Saudi Arabia Saudi Medical Journal 01.04.2017; Riyadh : Armed Forces Hospital
• Subjects: Adult; Analysis; Basilar Artery - diagnostic imaging; Case Report; Cerebral Angiography; Complications and side effects; Dosage and administration; Female; Humans; Milrinone; Milrinone - adverse effects; Risk factors; Subarachnoid hemorrhage; Subarachnoid Hemorrhage - drug therapy; Tomography, X-Ray Computed; Transient ischemic attack; Treatment outcome; Vasospasm, Intracranial - chemically induced; Vasospasm, Intracranial - diagnostic imaging
• ISSN: 1319-6138
• DOI: 10.17712/nsj.2017.2.20160451

Pretruncal (perimesencephalic) non-aneurysmal subarachnoid hemorrhage (PNSAH) is uniformly associated with an excellent outcome. Although cerebral vasospasm remains a common complication of SAH and constitutes an important predictor of outcome, in the setting of PNSAH, it is extremely rare. Preturnal non-aneurysmal subarac refers to a subset of SAH patients with a characteristic pattern of localized blood on CT of the head, normal cerebral angiography, and benign course when compared to the aneurysmal SAH population. The presence of radiological or even clinical vasospasm does not exclude the diagnosis of PNSAH. To our knowledge, this is the first case of symptomatic cerebral vasospasm due to PNSAH that responded to milrinone.