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Cerebral aneurysm presenting with aseptic meningitis: a case report.

Saleem MA, Macdonald RL - J Med Case Rep (2013)

Bottom Line: This case highlights the potential importance of new-onset headache, even in the absence of other worrisome features, in a patient with a cerebral aneurysm.A 61-year-old Caucasian woman presented with nonspecific insidious onset of headache, a superior cerebellar artery aneurysm and cerebrospinal fluid lymphocytosis.Headaches are common and may occur incidentally in patients with cerebral aneurysms, but new-onset headache, even if mild, should prompt consideration for timely aneurysm repair.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Neurosurgery, St, Michael's Hospital, Labatt Family Centre of Excellence in Brain Injury and Trauma Research, Keenan Research Centre of the Li Ka Shing Knowledge Institute of St, Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. macdonaldlo@smh.ca.

ABSTRACT

Introduction: This case highlights the potential importance of new-onset headache, even in the absence of other worrisome features, in a patient with a cerebral aneurysm.

Case presentation: A 61-year-old Caucasian woman presented with nonspecific insidious onset of headache, a superior cerebellar artery aneurysm and cerebrospinal fluid lymphocytosis. She had a subarachnoid hemorrhage 21 days later, at which time the aneurysm had enlarged. The aneurysm was repaired endovascularly and the patient recovered with a modified Rankin score of 1.

Conclusions: This case suggests that new onset of chronic headache in a patient with an unruptured aneurysm may be due to aneurysm growth and can be associated with cerebrospinal fluid lymphocytosis. Headaches are common and may occur incidentally in patients with cerebral aneurysms, but new-onset headache, even if mild, should prompt consideration for timely aneurysm repair.

No MeSH data available.


Related in: MedlinePlus

Cranial computed tomography scan 21 days after presentation. A cranial computed tomography scan 21 days after presentation showing diffuse subarachnoid hemorrhage (A) with hydrocephalus (B). The computed tomographic angiogram sagittal view (C) and lateral view of a reconstruction (D) show growth of the aneurysm on the anterior aspect.
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Figure 2: Cranial computed tomography scan 21 days after presentation. A cranial computed tomography scan 21 days after presentation showing diffuse subarachnoid hemorrhage (A) with hydrocephalus (B). The computed tomographic angiogram sagittal view (C) and lateral view of a reconstruction (D) show growth of the aneurysm on the anterior aspect.

Mentions: Twenty-one days after the first presentation, the patient presented with sudden onset of severe headache. Her Glasgow Coma Score was 15 and she was neurologically intact. A cranial CT scan showed diffuse, thin SAH, blood in the occipital horns of the lateral ventricles and acute hydrocephalus. Our patient deteriorated and when her Glasgow Coma Score was 10, an external ventricular drain was inserted. CT angiography showed a bilobed (anterior and posterior lobes) right superior cerebellar artery aneurysm that had slightly increased in size to approximately 0.6 by 1.0cm (FigureĀ 2).


Cerebral aneurysm presenting with aseptic meningitis: a case report.

Saleem MA, Macdonald RL - J Med Case Rep (2013)

Cranial computed tomography scan 21 days after presentation. A cranial computed tomography scan 21 days after presentation showing diffuse subarachnoid hemorrhage (A) with hydrocephalus (B). The computed tomographic angiogram sagittal view (C) and lateral view of a reconstruction (D) show growth of the aneurysm on the anterior aspect.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4016604&req=5

Figure 2: Cranial computed tomography scan 21 days after presentation. A cranial computed tomography scan 21 days after presentation showing diffuse subarachnoid hemorrhage (A) with hydrocephalus (B). The computed tomographic angiogram sagittal view (C) and lateral view of a reconstruction (D) show growth of the aneurysm on the anterior aspect.
Mentions: Twenty-one days after the first presentation, the patient presented with sudden onset of severe headache. Her Glasgow Coma Score was 15 and she was neurologically intact. A cranial CT scan showed diffuse, thin SAH, blood in the occipital horns of the lateral ventricles and acute hydrocephalus. Our patient deteriorated and when her Glasgow Coma Score was 10, an external ventricular drain was inserted. CT angiography showed a bilobed (anterior and posterior lobes) right superior cerebellar artery aneurysm that had slightly increased in size to approximately 0.6 by 1.0cm (FigureĀ 2).

Bottom Line: This case highlights the potential importance of new-onset headache, even in the absence of other worrisome features, in a patient with a cerebral aneurysm.A 61-year-old Caucasian woman presented with nonspecific insidious onset of headache, a superior cerebellar artery aneurysm and cerebrospinal fluid lymphocytosis.Headaches are common and may occur incidentally in patients with cerebral aneurysms, but new-onset headache, even if mild, should prompt consideration for timely aneurysm repair.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Neurosurgery, St, Michael's Hospital, Labatt Family Centre of Excellence in Brain Injury and Trauma Research, Keenan Research Centre of the Li Ka Shing Knowledge Institute of St, Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. macdonaldlo@smh.ca.

ABSTRACT

Introduction: This case highlights the potential importance of new-onset headache, even in the absence of other worrisome features, in a patient with a cerebral aneurysm.

Case presentation: A 61-year-old Caucasian woman presented with nonspecific insidious onset of headache, a superior cerebellar artery aneurysm and cerebrospinal fluid lymphocytosis. She had a subarachnoid hemorrhage 21 days later, at which time the aneurysm had enlarged. The aneurysm was repaired endovascularly and the patient recovered with a modified Rankin score of 1.

Conclusions: This case suggests that new onset of chronic headache in a patient with an unruptured aneurysm may be due to aneurysm growth and can be associated with cerebrospinal fluid lymphocytosis. Headaches are common and may occur incidentally in patients with cerebral aneurysms, but new-onset headache, even if mild, should prompt consideration for timely aneurysm repair.

No MeSH data available.


Related in: MedlinePlus