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- Thomas Ritzenthaler, Florent Gobert, and Fréderic Dailler.
- Neurological Intensive Care Unit, Civil Hospices of Lyon, Bron, Cedex, France. Electronic address: thomas.ritzenthaler@chu-lyon.fr.
- World Neurosurg. 2019 Apr 1; 124: 295297295-297.
BackgroundSecondary brain injuries, such as delayed cerebral infarction (DCI), are the leading causes of disability after subarachnoid hemorrhage (SAH). Detecting DCI may be challenging, especially for patients presenting an altered level of consciousness.Case DescriptionWe describe herein the case of a patient who developed acute hemiplegia 4 days after SAH, with raised blood flow velocities on transcranial Doppler, compatible with vasospasm. Finally, full work-up, using computed tomography (CT) scan with perfusion CT and continuous electroencephalography, was consistent with nonconvulsive seizures.ConclusionsMultiple secondary complications (DCI, seizures, hydrocephalus) may occur after SAH but are clinically difficult to diagnose. A multimodal evaluation (transcranial Doppler, CT or magnetic resonance imaging, electroencephalography) is useful in order to detect and treat late complications.Copyright © 2019 Elsevier Inc. All rights reserved.
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