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  • Title: [Pontine stroke due to vasospasm secondary to perimesencephalic subarachnoid hemorrhage].
    Author: Mayor S, Erro ME, Zazpe I, Gállego J.
    Journal: Neurologia; 2008 May; 23(4):256-8. PubMed ID: 18516747.
    Abstract:
    INTRODUCTION: Spontaneous non-aneurysmal subarachnoid hemorrhages generally have a good short and long term outcome, especially those with a perimesencephalic location. Vasospasm is an uncommon complication of this type of subarachnoid hemorrhage, and ischemic cerebral lesions related to vasospasm are even less frequent. CASE REPORT: A 46 year-old man was admitted with a perimesencephalic subarachnoid hemorrhage. Angiographic study performed on admission was normal. Two weeks later he developed dysarthria and right faciobrachial paresis. Transcranial doppler showed a diffuse and moderate increase of medium velocity flow at basilar artery level suggestive of moderate vasospasm. An angioresonance confirmed this finding and a paramedian pontine infarction was found on resonance images. The patient was treated with nimodipine and he was discharged from hospital with only mild residual deficit. CONCLUSION: Cerebral infarction related to vasospasm as complication of subarachnoid perimesencephalic hemorrhage is exceptional. The factors that could have been involved in the development of this complication are discussed.
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