Subarachnoid haemorrhage due to intracranial vertebral artery dissection presenting with atypical cauda equina syndrome features: case report.
BMC Neurol
; 19(1): 262, 2019 Oct 30.
Article
em En
| MEDLINE
| ID: mdl-31666024
ABSTRACT
BACKGROUND:
Failing to recognise the signs and symptoms of subarachnoid haemorrhage (SAH) causes diagnostic delay and may result in poorer outcomes. We report a rare case of SAH secondary to a vertebral artery dissection (VAD) that initially presented with cauda equina-like features, followed by symptoms more typical of SAH. CASE PRESENTATION A 55-year-old man developed severe lower back pain after sudden movement. Over the next 5 days he developed paraesthesiaes in the feet, progressing to the torso gradually, and reported constipation and reduced sensation when passing urine. On day six he developed left facial palsy, and later gradual-onset headache and intermittent confusion. Magnetic resonance imaging of the brain showed diffuse subarachnoid FLAIR hyperintensity, concerning for blood, including a focus of cortical/subcortical high signal in the left superior parietal lobule, which was confirmed by computed tomography. Digital subtraction angiography demonstrated a left VAD with a fusiform aneurysm.CONCLUSION:
We present a very rare case of intracranial VAD with SAH initially presenting with spinal symptoms. The majority of subsequent clinical features were consistent with a parietal focus of cortical subarachnoid blood, as observed on neuroimaging.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Hemorragia Subaracnóidea
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Aneurisma Intracraniano
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Dissecação da Artéria Vertebral
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Síndrome da Cauda Equina
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article