Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Contralateral Intraparenchymal Hemorrhage Following Aneurysmal Clipping

  • Kim, Jae-Hoon (Department of Neurosurgery, Nowon Eulji Hospital) ;
  • Yi, Hyeong-Joong (Department of Neurosurgery, Hanyang University Medical Center)
  • Published : 2008.03.18
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Abstract

Post-clipping intraparenchymal hemorrhage of the contralateral hemisphere is a very unusual phenomenon in a patient with aneurysmal subarachnoid hemorrhage, unless there is an underlying condition. We report a complicated case of 47-year-old man, who underwent uneventful clipping of ruptured aneurysm and experienced vasospasm two weeks later. Vasospasm was treated by intra-arterial nimodipine and systemic hyperdynamic therapy. One week thereafter, he became unconscious due to intraparenchymal hemorrhage on the anterior border-zone of contalateral hemisphere, but intraoperative and pathologic findings failed to disclose any vascular anomaly. We suggest that the anti-spastic regimens cause local hemodynamic redistribution through the vasodilatory effect and in turn, resulted in such an unexpected bleeding.

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References

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