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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We reported a case of a 33-year-old woman who presented a subarachnoid hemorrhage due to rupture of an aneurysm arising from the ambient segment of the superior cerebellar artery (SCA). The patient who complained of severe headache and nausea was admitted on April 6, 1996. A CT scan revealed subarachnoid hemorrhage in the left cerebellopontine cistern. Left vertebral angiography showed a fusiform type aneurysm of the ambient segment of the left SCA. Trapping of the aneurysm was successfully performed via the subtemporal approach on the day of admission, April 6, 1996. She was discharged with no deficits on May 2, 1996. Fusiform type aneurysm arising from SCA is very rare. Only 3 cases have been reported in the literature. We discussed the pathogenesis of this aneurysm and the timing of surgery.
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PMID:[A case of peripheral, fusiform type aneurysm originating from the superior cerebellar artery]. 951 98

A 27-year-old male presented with a rare association of a ruptured orbitofrontal artery aneurysm and a dural arteriovenous malformation (DAVM) fed by both ethmoidal arteries, manifestation as severe headache, nausea, and vomiting. Computed tomography revealed a hematoma within the right frontal lobe and diffuse subarachnoid hemorrhage. The aneurysm was clipped successfully and the hematoma was evacuated. After an uneventful postoperative course, the patient was referred for gamma knife radiosurgery to treat the DAVM. In this case, the DAVM was asymptomatic and pathogenetically unrelated to the aneurysm, which demanded urgent treatment.
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PMID:Ruptured aneurysm of the orbitofrontal artery associated with dural arteriovenous malformation in the anterior cranial fossa--case report. 1019 50

A 65-year-old woman suddenly developed severe headache with nausea. Computed tomographic scans revealed a diffuse subarachnoid hemorrhage with thick hematoma of the left ambient cistern. Cerebral angiogram did not show any aneurysm. On the 7th day after admission, 3D-CT angiogram showed an aneurysm of the left posterior cerebral artery. On the 14th day, axial and coronal magnetic resonance images showed the aneurysm, surrounding structures and the choroidal fissure. On the 26th day after admission, successful neck clipping was performed through the temporal horn via the inferior temporal gyrus. The postoperative course was uneventful except for transient aphasia. This approach may be preferable in such cases, because it protects the brain from the detrimental effects of strong temporal retraction and provides a wider working space. In our case, thin slice MRI and MRA showing the aneurysm in the ambient cistern and the choroidal fissure were useful for deciding the appropriate approach.
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PMID:[Clipping of an aneurysm of the posterior cerebral artery via the transcortical transchoroidal-fissure approach: a case report]. 1064 99

A 57-year-old female was admitted to our hospital because of headache, nausea, and vomiting. Head CT scan demonstrated subarachnoid hemorrhage. Cerebral angiography showed the absence of the right internal carotid artery, and skull base CT of the bone window level revealed the absence of the right carotid canal. The right middle cerebral artery (MCA) and anterior cerebral artery (ACA) were opacified from the left internal carotid artery. The right A1 portion was hypoplastic and the distal portion of the right M1 portion was replaced by several minute complicated anastomotic vessels connected to the right M2 portion. The right MCA territory was mainly supplied by collateral flow from the right ACA and the right posterior cerebral artery via the leptomeningeal anastomosis. These was neither aneurysm nor arteriovenous malformation. The second angiography, 1 week after the initial angiography, showed the same hemodynamic pattern and aneurysms were not found. We diagnosed the patient as agenesis of the right internal carotid artery and the etiology of subarachnoid hemorrhage was suspected to be a rupture of the anastomotic vessels between the right M1 and M2. She was discharged on the 21st hospital day without any neurological deficit.
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PMID:[Agenesis of the right internal carotid artery associated with complicated anastomosis of middle cerebral artery: a case report]. 1087 12

A 61-year-old male with hypertension presented with sudden onset of headache and nausea due to subarachnoid hemorrhage (SAH). He had two siblings with history of SAH due to ruptured intracranial aneurysms. Right carotid angiography on admission showed an anterior communicating artery aneurysm. At that time, the extracranial arteries were not examined. The aneurysm was clipped with no complications. A pulsating mass was palpable in the abdomen 37 days after the onset. Ultrasonography and computed tomography showed an abdominal aortic aneurysm with intraluminal thrombus, measuring 8 x 9 x 8 cm. Normal pressure hydrocephalus had already developed. The patient underwent elective abdominal aortic aneurysm resection before ventriculoperitoneal shunting. After shunting, he recovered fully. The present case indicates that unpredictable sudden enlargement of associated abdominal aortic aneurysm is possible in patients with ruptured intracranial aneurysms.
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PMID:Ruptured intracranial aneurysm associated with unruptured abdominal aortic aneurysm--case report. 1139 6

A 28-year-old woman suffered severe back pain and headache during exercising on three occasions during the prior two-month period. On admission, the physical examination revealed symptoms of meningeal irritation, nuchal rigidity, severe headache, continuous nausea, and vomiting. Cerebral computed tomography of the intracranial subarachnoidal space revealed no subarachnoid hemorrhage. Her cerebrospinal fluid was bloody. Spinal magnetic resonance imaging identified a posterior mediastinal tumor adherent to the left side of the 5th thoracic vertebra and an abnormally expanded blood vessel near the mediastinal tumor. In addition, a high signal intensity lesion appeared to be present on the surface of the spinal cord. A mediastinal neoplasm was removed through standard thoracotomy. During surgery, marked enlargement was noted in some veins (hemiazygos and 5th intercostal veins) which apparently had been constricted by the mediastinal tumor. Surgical and radiological findings suggested a relationship between the constricted venous return due to the tumor and the patient's spinal subarachnoid hemorrhage.
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PMID:Mediastinal neurilemmoma complicated with spinal subarachnoid hemorrhage. 1148 44

A case of iatrogenic intracranial artery dissection is reported. A 52-year-old female developed severe headache and nausea. Brain CT showed diffuse subarachnoid hemorrhage. On admission, carotid angiography revealed an aneurysm in the right middle cerebral artery and the intact right internal carotid artery. The aneurysm was clipped successfully. Carotid angiography on day 7 revealed dissection in the right internal carotid artery. Repeated angiograms at 10 and 31 days showed progression of the carotid artery dissection. Findings of ECD-SPECT on day 31 (Balloon occlusion test) suggested low perfusion of the right internal carotid artery territory. The patient underwent surgical reconstruction of the right internal carotid artery using a radial artery. She presented with right abducens nerve palsy three days after the radial artery graft. The patency of the radial artery graft was proved by the post-operative angiography. Internal carotid artery dissection may occur spontaneously or as a result of trauma. An iatrogenic dissection is an uncommon complication of cerebral angiography. There are no evidence-based guidelines for the treatment although anticoagulation therapy is most commonly used. The present case emphasizes the usefulness of radial artery graft for traumatic carotid artery dissection.
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PMID:[A case of iatrogenic carotid artery dissection treated with radial artery graft]. 1159 67

A 64-year-old male suddenly developed headache and nausea. He had been pointed 3 years before out as having an unruptured basilar artery aneurysm and a right middle cerebral artery aneurysm. Computed tomography (CT) revealed diffuse subarachnoid hemorrhage in the basal cistern and bilateral Sylvian and interhemispheric fissures. Hematomas in the anterior horns of the lateral ventricles and third ventricle were also seen. Angiography revealed an anterior communicating artery aneurysm, which, retrospectively, had been recognized as a small dilatation of artery wall 3 years before. An operation was performed and the anterior communicating artery aneurysm was successfully clipped. The intraoperative findings revealed the aneurysm was the ruptured one. The risk of rupture and surgical indication for unruptured small aneurysms are discussed.
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PMID:[A case of a ruptured anterior communicating aneurysm which was originally the smallest of several unruptured aneurysms]. 1196 28

Sudden onset headache is a common condition that sometimes indicates a life-threatening subarachnoid haemorrhage (SAH) but is mostly harmless. We have performed a prospective study of 137 consecutive patients with this kind of headache (thunderclap headache=TCH). The examination included a CT scan, CSF examination and follow-up of patients with no SAH during the period between 2 days and 12 months after the headache attack. The incidence was 43 per 100 000 inhabitants >18 years of age per year; 11.3% of the patients with TCH had SAH. Findings in other patients indicated cerebral infarction (five), intracerebral haematoma (three), aseptic meningitis (four), cerebral oedema (one) and sinus thrombosis (one). Thus no specific finding indicating the underlying cause of the TCH attack was found in the majority of the patients. A slightly increased prevalence of migraine was found in the non-SAH patients (28%). The attacks occurred in 11 cases (8%) during sexual activity and two of these had an SAH. Nausea, neck stiffness, occipital location and impaired consciousness were significantly more frequent with SAH but did not occur in all cases. Location in the temporal region and pressing headache quality were the only features that were more common in non-SAH patients. Recurrent attacks of TCH occurred in 24% of the non-SAH patients. No SAH occurred later in this group, nor in any of the other patients. It was concluded that attacks caused by a SAH cannot be distinguished from non-SAH attacks on clinical grounds. It is important that patients with their first TCH attack are investigated with CT and CSF examination to exclude SAH, meningitis or cerebral infarction. The results from this and previous studies indicate that it is not necessary to perform angiography in patients with a TCH attack, provided that no symptoms or signs indicate a possible brain lesion and a CT scan and CSF examination have not indicated SAH.
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PMID:Sudden onset headache: a prospective study of features, incidence and causes. 1211 Jan 11

Subarachnoid haemorrhage secondary to closed head injury is rarely associated with traumatic aneurysms of the posterior circulation. We report two cases of ruptured vertebral-posterior inferior cerebellar artery (VA-PICA) pseudoaneurysms following closed head injuries. In each case, there was no associated penetrating injury or skull fracture. The first patient was kicked followed by disturbed consciousness. The computerized tomography (CT) scan on admission and cerebral angiography on the 11th day after the trauma revealed a massive subarachnoid haemorrhage (SAH) with pan-ventricular haemorrhage and an aneurysm of the right PICA near its origin. Further ruptures occurred on the 12th, 15th, and 66th day, and he died on the 69th day. The second patient complained of persistent headache and nausea following a fight on the previous day. A CT scan and angiography on the 1st day after the trauma showed posterior fossa SAH with fourth ventricular blood and a tiny protrusion of the left VA-PICA. On the 14th day, repeated angiography revealed a remarkable growth of the aneurysm, followed by the second rupture. The repair of the VA-PICA junction was urgently performed with successful exclusion of the aneurysm. To our knowledge, only eight cases of traumatic aneurysms located at the VA or the PICA near its origin have been reported. When intraventricular blood is found with massive subarachnoid blood or with posterior fossa SAH, this ominous complication should be considered. Traumatic VA-PICA pseudoaneurysms are curable by refined microsurgical techniques, if diagnosed in time.
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PMID:Unexpected delayed rupture of the vertebral-posterior inferior cerebellar artery aneurysms following closed head injury. 1218 96


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