Skip to main content

Main menu

  • Home
  • Content
    • Latest
    • Ahead of print
    • Archive
  • Info for
    • Authors
    • Reviewers
    • Subscribers
    • Institutions
    • Advertisers
  • About Us
    • About Us
    • Editorial Office
    • Editorial Board
  • More
    • Alerts
    • Feedback
    • Folders
    • Help
  • Other Publications
    • Saudi Medical Journal

User menu

  • My alerts
  • Log in

Search

  • Advanced search
Neurosciences Journal
  • Other Publications
    • Saudi Medical Journal
  • My alerts
  • Log in
Neurosciences Journal

Advanced Search

  • Home
  • Content
    • Latest
    • Ahead of print
    • Archive
  • Info for
    • Authors
    • Reviewers
    • Subscribers
    • Institutions
    • Advertisers
  • About Us
    • About Us
    • Editorial Office
    • Editorial Board
  • More
    • Alerts
    • Feedback
    • Folders
    • Help
  • Follow psmmc on Twitter
  • Visit psmmc on Facebook
  • RSS
LetterCorrespondence
Open Access

Subdural hematoma caused by rupture of a posterior cerebral artery aneurysm

Mahmood D. Al-Mendalawi
Neurosciences Journal October 2016, 21 (4) 374-375; DOI: https://doi.org/10.17712/nsj.2016.4.20160388
Mahmood D. Al-Mendalawi
Department of Pediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad, Iraq
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • eLetters
  • Info & Metrics
  • References
  • PDF
Loading

To the Editor

We have read with interest the case report by Feng et al1 on the subdural hematoma (SDH) caused by rupture of a posterior cerebral artery (PCA) aneurysm. It is noteworthy that the etiology of intracranial aneurysm formation and rupture remains mostly unknown, but multiple genetic susceptibilities in conjunction with the environmental factors are considered to act together in the etiology.2 An acute SDH is a rare complication of aneurysmal subarachnoid hemorrhage (SAH) and it is associated with a poor clinical condition on admission and a poor outcome. Increasing age, sentinel headache, intracerebral hemorrhage, and aneurysms at the posterior communicating artery are independent risk factors for an acute SDH. However, patients with a basilar or vertebral aneurysm have a low risk of an acute SDH.3 The available data pointed out that cerebrovascular complications of human immunodeficiency virus (HIV) infection/ AIDS were reported as high as 34% in post mortem series. Most HIV infected patients suffered from ischemic strokes but there are a number of reports of patients presenting with SAH related specifically to aneurysm rupture.4 In a recently published literature review, it was observed that the relationship between HIV infection and the formation of aneurysms appears to be real.5 Though the Chinese national HIV infection prevalence is still low (0.0598%) and new HIV infections have been contained at a low level (50,000-100,000 each year),6 HIV infection is still considered an important health threat. I presume that HIV infection- associated PCA aneurysm ought to be considered and its rupture had contributed to the development of SDH in the case in question. Hence, CD4 count and viral overload estimations were solicited to be contemplated.

Reply from the Author

We appreciate the insightful comments of Prof. Al-Mendalawi on our article.1 Prof. Mahmood Al-Mendalawi put forward a valuable point that HIV infection-associated aneurysms ought to be considered in cerebral artery aneurysms. We thoroughly agree with him that infection related examinations should be performed in cerebral aneurysms and their rupture caused intracranial hemorrhage.

Infectious intracranial aneurysms (IIA) are rare, which account for 0.7-5.4% of all intracranial aneurysms.7 Various infectious pathogens can cause cerebral aneurysms, whose rupture may lead to intracranial hemorrhage, by injuring the vascular wall.8 The most common organism linked to infectious intracranial aneurysms (IIA) is bacteria,9 and we have ever reported a bacterial endocarditis associated distal cerebral aneurysm of adolescent.10 Also, HIV, which can directly invade the central nervous system (CNS) in a short time after systemic infection, was reported to cause IIAs.11 Though it is rare, parasites infection associated IIAs were reported from time to time.8 For instance, we have reported cerebral aneurysms associated with cerebral paragonimiasis.12

Posterior cerebral artery aneurysms may be associated with vascular malformation, infection, head trauma and so on.13 In our case, the total white blood cell count of the patient was normal. And he had no history of blood transfusion or relevant history of HIV infection. In addition, the HIV antibody and HIV p24 antigen enzyme-linked immunosorbent assay (ELISA) tests were negative. And the ELISA tests for multiple parasites performed on his serum were also negative. Based on these data, we did not consider infection-associated PCA aneurysm in this case. Because of the lack of a known origin, we finally considered it was an idiopathic dissecting aneurysm.

Zhou Feng, Zhi Chen

Department of Neurosurgery, Southwest Hospital, Third Military Medical University Chongqing, The People’s Republic of China

  • Copyright: © Neurosciences

Neurosciences is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work.

References

  1. ↵
    1. Feng Z,
    2. Tan Q,
    3. Li L,
    4. Chen Z
    (2016) Subdural hematoma caused by rupture of a posterior cerebral artery aneurysm. Neurosciences (Riyadh) 21, 161–163.
  2. ↵
    1. Krischek B,
    2. Tatagiba M
    (2008) The influence of genetics on intracranial aneurysm formation and rupture: current knowledge and its possible impact on future treatment. Adv Tech Stand Neurosurg 33, 131–147.
  3. ↵
    1. Biesbroek JM,
    2. Rinkel GJ,
    3. Algra A,
    4. van der Sprenkel JW
    (2012) Risk factors for acute subdural hematoma from intracranial aneurysm rupture. Neurosurgery 71, 264–268, discussion 268-9.
  4. ↵
    1. Taylor A,
    2. Lefeuvre D,
    3. Levy A,
    4. Candy S
    (2004) Arterial dissection and subarachnoid haemorrhage in human immunodeficiency virus-infected patients. A report of three cases. Interv Neuroradiol 10, 137–143.
  5. ↵
    1. Pagiola IC,
    2. Paiva AL,
    3. de Aguiar GB,
    4. de Oliveira AC,
    5. Conti ML,
    6. Gagliardi RJ
    (2016) Cerebral aneurysms associated with human immunodeficiency virus in adults: literature review and new perspectives. Rev Assoc Med Bras (1992) 62, 85–89.
  6. ↵
    1. Huang MB,
    2. Ye L,
    3. Liang BY,
    4. Ning CY,
    5. Roth WW,
    6. Jiang JJ,
    7. et al.
    (2015) Characterizing the HIV/AIDS Epidemic in the United States and China. Int J Environ Res Public Health 13, ijerph13010030.
  7. ↵
    1. Dhomne S,
    2. Rao C,
    3. Shrivastava M,
    4. Sidhartha W,
    5. Limaye U
    (2008) Endovascular management of ruptured cerebral mycotic aneurysms. Br J Neurosurg 22, 46–52.
  8. ↵
    1. Fugate JE,
    2. Lyons JL,
    3. Thakur KT,
    4. Smith BR,
    5. Hedley-Whyte ET,
    6. Mateen FJ
    (2014) Infectious causes of stroke. Lancet Infect Dis 14, 869–880.
  9. ↵
    1. Ducruet AF,
    2. Hickman ZL,
    3. Zacharia BE,
    4. Narula R,
    5. Grobelny BT,
    6. Gorski J,
    7. et al.
    (2010) Intracranial infectious aneurysms: a comprehensive review. Neurosurg Rev 33, 37–46.
  10. ↵
    1. Chen Z,
    2. Miao H,
    3. Feng H,
    4. Zhu G
    (2011) Rupture of an infectious intracranial aneurysm involving two parent arteries after surgical treatment of infective endocarditis. Neurosciences (Riyadh) 16, 72–75.
  11. ↵
    1. Modi G,
    2. Ranchod K,
    3. Modi M,
    4. Mochan A
    (2008) Human immunodeficiency virus associated intracranial aneurysms: report of three adult patients with an overview of the literature. J Neurol Neurosurg Psychiatry 79, 44–46.
  12. ↵
    1. Chen Z,
    2. Chen J,
    3. Miao H,
    4. Li F,
    5. Feng H,
    6. Zhu G
    (2013) Angiographic findings in 2 children with cerebral paragonimiasis with hemorrhage. J Neurosurg Pediatr 11, 564–567.
  13. ↵
    1. Honda M,
    2. Tsutsumi K,
    3. Yokoyama H,
    4. Yonekura M,
    5. Nagata I
    (2004) Aneurysms of the posterior cerebral artery: retrospective review of surgical treatment. Neurol Med Chir (Tokyo) 44, 164–168, discussion 169.
PreviousNext
Back to top

In this issue

Neurosciences Journal: 21 (4)
Neurosciences Journal
Vol. 21, Issue 4
1 Oct 2016
  • Table of Contents
  • Cover (PDF)
  • Index by author
Print
Download PDF
Email Article

Thank you for your interest in spreading the word on Neurosciences Journal.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Subdural hematoma caused by rupture of a posterior cerebral artery aneurysm
(Your Name) has sent you a message from Neurosciences Journal
(Your Name) thought you would like to see the Neurosciences Journal web site.
Citation Tools
Subdural hematoma caused by rupture of a posterior cerebral artery aneurysm
Mahmood D. Al-Mendalawi
Neurosciences Journal Oct 2016, 21 (4) 374-375; DOI: 10.17712/nsj.2016.4.20160388

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Subdural hematoma caused by rupture of a posterior cerebral artery aneurysm
Mahmood D. Al-Mendalawi
Neurosciences Journal Oct 2016, 21 (4) 374-375; DOI: 10.17712/nsj.2016.4.20160388
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Bookmark this article

Jump to section

  • Article
    • References
  • eLetters
  • References
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Comment on: Sleep patterns and quality depend not only on gender and the time of year, but also on a variety of other influencing factors
  • Comment on: When assessing the risk of cerebral edema after aneurysm clipping, all contributing factors must be taken into account
  • Comment on: Critically ill neuropathy alone is sufficient to explain proximal limb weakness and femoral nerve damage in severe SARS-CoV-2 infection
Show more Correspondence

Similar Articles

Navigate

  • home

More Information

  • Help

Additional journals

  • All Topics

Other Services

  • About

© 2025 Neurosciences Journal Neurosciences is copyright under the Berne Convention and the International Copyright Convention. All rights reserved. Neurosciences is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work. Electronic ISSN 1658-3183. Print ISSN 1319-6138.

Powered by HighWire