J Cerebrovasc Endovasc Neurosurg.  2016 Mar;18(1):27-31. 10.7461/jcen.2016.18.1.27.

Delayed Vasospasm after Aneurysmal Subarachnoid Hemorrhage in Behcet Syndrome

• Kim JH
• Lee SU
• Huh C
• Oh CW
• Bang JS
• Kim T

• KMID: 2161699
• DOI: http://doi.org/10.7461/jcen.2016.18.1.27

Abstract

A man visited the emergency room with a headache. Brain computed tomography showed aneurysmal subarachnoid hemorrhage (SAH) and multiple aneurysms. After aneurysm clipping surgery, the patient was discharged. After 5 days, he was admitted to the hospital with skin ulceration and was diagnosed with Behcet syndrome. An angiogram taken 7 weeks after aneurysmal SAH showed intracranial vasospasm. Because inflammation in Behcet syndrome may aggravate intracranial vasospasm, intracranial vasospasm after aneurysmal SAH in Behcet syndrome should be monitored for longer compared to general aneurysmal SAH.

Keyword

Behcet syndrome; Vasospasm; Subarachnoid hemorrhage

MeSH Terms

Aneurysm*
Behcet Syndrome*
Brain
Emergency Service, Hospital
Headache
Humans
Inflammation
Skin Ulcer
Subarachnoid Hemorrhage*
Vasospasm, Intracranial

Figure

• 

  Fig. 1 (A, B) Digital subtraction angiography (DSA) showing vasospasms in both the middle cerebral artery (MCA) and the anterior cerebral artery (ACA) on admission. Note the intracranial multiple aneurysms in both the MCA and the anterior communicating artery). (C, D) DSA showing resolved vasospasms in the MCA (arrow) and ACA before discharge.

• 

  Fig. 2 (A, B) Digital subtraction angiography (DSA) performed in the 7th week after subarachnoid hemorrhage shows vasospasms in both the middle cerebral artery (MCA) and the anterior cerebral artery (ACA) and the disappearance of multiple intracranial aneurysms. (C, D) DSA showing total occlusion of the left MCA. (E, F) DSA showing patent blood flow after left MCA-superficial temporal artery (STA) anastomosis.

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