Laceration of the posterior inferior cerebellar artery by suboccipital puncture of the cisterna magna: case report

Arquivos de Neuro-Psiquiatria

Luiz Antonio Pezzi Portela¹  Valéria Souza¹  Félix Hendrick Pahl¹  Alberto Cappel Cardoso¹  Eduardo De Arnaldo Silva Vellutini¹  Eduardo Genaro Mutarelli¹  Luis Dos Ramos Machado¹  José Antonio Livramento¹ 

[1] ,Hospital Alemão Oswaldo CruzSão Paulo SP ,Brazil

关键词: CSF;    suboccipital puncture;    angiogram;    posterior inferior cerebellar artery;    pseudoaneurysm;    laceration;    LCR;    punção suboccipital;    artéria cerebelar póstero-inferior;    angiografia;    pseudoaneurisma;    laceração;   

DOI  :  10.1590/S0004-282X2004000500028

来源: SciELO

【 摘 要 】

We report the case of a 27 year old man who presented to the emergency room of a hospital with headache, vomiting and an episode of loss of conciousness. A cranial CT scan was normal and the patient discharged. Ten hours later he came to the emergency room of our hospital with the same complaints. A technically difficult cisternal puncture in an anxious patient who moved during the needle introduction was done. The CSF sample showed 1600 intact red blood cells without other alterations. His headache worsened and after 6 hours he became drowsy, numb and exhibited decerebration signs. A new CT scan showed diffuse subarachnoid and intraventricular blood. An emergency angiogram demonstrated laceration of a left posterior-inferior cerebellar artery in its retrobulbar loop with a pseudoaneurysm. He was succesfully treated by surgical clipping without injury. Sixteen days later he was discharged with a normal neurological exam.

【 授权许可】

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