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Stroke
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
A hemorrhagic stroke results from cerebral vessel ruptures, such as in intracerebral hemorrhage or subarachnoid hemorrhage. Hemorrhagic stroke makes up 20% of all cases of CVAs. Intracerebral hemorrhage is defined as focal bleeding from a vessel within the parenchyma of the brain, usually because of hypertension. This type of stroke usually occurs in the basal ganglia, cerebral lobes, cerebellum, or pons. However, it can occur in other areas of the brainstem or midbrain. Subarachnoid hemorrhage is sudden bleeding into the subarachnoid space, usually because of a ruptured aneurysm. Type 2 diabetes mellitus is associated with a higher incidence of hemorrhagic stroke.
The nervous system and the eye
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
James A.R. Nicoll, William Stewart, Fiona Roberts
The brain and spinal cord are enclosed by three membranous layers collectively referred to as the meninges; these comprise the dura mater, arachnoid mater and pia mater. The dura mater acts as the periosteum to the skull and spine. Extensions of the dura – the falx cerebri and the tentorium cerebelli (Figure 12.1) – subdivide the cranial cavity into three spaces, two supratentorial and one infratentorial (the posterior fossa). The subdural space lies between the dura and the outer surface of the arachnoid, and blood or pus can spread widely throughout it. The arachnoid lies in contact with the dura; the pia is closely attached to the brain. The subarachnoid space is filled with cerebrospinal fluid (CSF). It is widest in the basal cisterns and within sulci. It contains the major cerebral arteries and veins, branches from which pass to and from the brain.
Negative Contrast Myelography
Published in Milosh Perovitch, Radiological Evaluation of the Spinal Cord, 2019
The measurements of the subarachnoid space and spinal cord were the subject of many published extensive studies mentioned in Chapter 1 (Volume 1). We performed a series of measurements using various myelographic techniques. In 1967, we carried out a comparative study of the diameter of the spinal cord under normal and manifold pathologic conditions by means of gas myelography. Although some investigators attribute considerable diagnostic value to the measurements, we have become reluctant to fully rely upon them on the basis of obtained results with the above mentioned study. The measurements of the diameters of the spinal cord performed on a series of gas polytomograms represented a detailed and time-consuming task. The achieved results did not permit a precise conclusion concerning the state of the spinal cord. Thus, small intramedullary tumors will not be detected at all times, and an initial atrophy of the spinal cord can be easily missed as explained in the first chapter.
The rare manifestations in tuberculous meningoencephalitis: a review of available literature
Published in Annals of Medicine, 2023
Rong li He, Yun Liu, Quanhui Tan, Lan Wang
Subarachnoid haemorrhage refers to the blood flowing into the subarachnoid space after the blood vessels at the bottom of the brain or on the surface of the brain break, leading to the corresponding clinical symptoms. Subarachnoid haemorrhage is rare in tuberculous meningoencephalitis. Only a few literatures have reported this phenomenon. The main clinical manifestation is sudden severe headache, with or without nausea, vomiting and other symptoms [14]. At present, the aetiology of TBM with SAH is still unclear. At present, its pathogenesis is considered to be related to TBM vasculitis and late inflammatory reaction, which may lead to subarachnoid haemorrhage [15]. Pathological examination also showed that subarachnoid haemorrhage may be related to the rupture of inflammatory tuberculoma or fungal aneurysm [16]. The diagnosis of subarachnoid haemorrhage mainly depends on the clinical manifestations. Cranial CT is the first choice for imaging diagnosis, and the positive rate is about 85%. Head CT shows diffuse high-density images of basal cistern, ventricular system and convexity of brain. Intracranial arterial lesions can also be detected by digital subtraction DSA of the whole cranial artery and MRA of the intracranial artery magnetic resonance angiography. The main causes of subarachnoid haemorrhage are aneurysm rupture and haemorrhage [17]. The clinical manifestations of patients with nodular encephalopathy suddenly appear in the course of the disease, which can be diagnosed in combination with the corresponding changes of head CT.
A clinical prediction of skin to subarachnoid space depth in parturients undergoing caesarean delivery in a Nigerian population
Published in Journal of Obstetrics and Gynaecology, 2022
Simeon Olugbade Olateju, Adedapo Omowonuola Adetoye, Olurotimi Idowu Aaron, Sanyaolu Alani Ameye, Adebose Ibukunoluwa Oria, Patrick Nduyari Olomu, Olumide Adedotun Adeniyi, Aramide Folayemi Faponle
Even though use of ultrasonography to determine correct needle depth is becoming increasingly common in developed countries (Gnaho et al.2012), this imaging modality is rarely available in resource poor countries. Also, use of traditional landmarks for depth determination was found to be as accurate as ultrasonography (Shankar et al.2021). A recent multicentre study found that extra-long spinal needles were rarely required in obese parturients (Olateju et al.2021). However, prediction of subarachnoid space depth (SSD) using formulae may be needed even with conventional spinal needles. Studies (Prakash et al.2014, Taman et al.2016) have determined SSD using formulae in their Indian and Egyptian parturient population, respectively. Considering the differences in body habitus between Sub-Saharan Africans and these populations, it is unclear whether these formulae are applicable in our patients. We, therefore, set out to determine the optimal formula for predicting SSD in this group of African parturients and to evaluate the applicability of previously described formulae.
Relationship between subarachnoid and central canal hemorrhage and spasticity: A first experimental study
Published in The Journal of Spinal Cord Medicine, 2021
Selim Kayaci, Mehmet Dumlu Aydin, Baris Ozoner, Tayfun Cakir, Orhan Bas, Sare Sipal
When a patient presents with cerebral SAH, the focus is generally on the localization of the blood in the subarachnoid space of the brain, cisterns, and ventricles. If it is a spontaneous SAH, the underlying aneurysm can be investigated. To identify anatomical characteristics, numerous radiological procedures, such as digital subtraction angiography, computed tomography-angiography, magnetic resonance imaging angiography are performed. However, whether the blood in the cerebral subarachnoid space passes through the spinal central canal and spinal subarachnoid space is not commonly investigated during routine procedures. Meanwhile, as described in this experimental study, cerebral SAH can pass through the spinal subarachnoid space and the central canal by passing from the cranial to caudal area.