{
    "abstract": "Convexity subarachnoid and intra-cerebral hemorrhages, in patients aged<50 years, are always a diagnostic challenge. This condition is characterized by acute headaches with or without neurological symptoms and/or seizures, and by the radiological demonstration of subarachnoid and/or intra-cerebral hemorrhages and, more rarely, by the association of ischemic events.\nIn a prospective series of 30 consecutive patients (median age 31 years; 22 women) with a subarachnoid and intra-cerebral hemorrhages, 19 were diagnosed with reversible cerebral vasoconstriction syndrome (RCVS), 7 with cerebral venous sinus thrombosis (CVST), and 4 with a bleeding mycotic aneurysm (MA).\nRCVS appeared spontaneously in 16 patients and was related to the postpartum period in three cases. Subarachnoid hemorrhage (SAH) was demonstrated in 24 patients as follows: 18 cases were in cortical areas, 4 were in the polygon of Willis, one was inter-hemispheric, and one was inter-hemispheric/intra-cerebral. A convexity pure intra-cerebral hemorrhage (ICH) was recorded in 6 cases. Among the 7 patients suffering from CVST, the superior sagittal sinus was involved in 4 cases, the transverse sinuses (TS) in 2, and the TS plus sigmoid sinus (SS) in one.\nThe three most common causes in this series were RCVS, followed by CVST and bleeding from MA. Because of atypical clinical or radiological presentations, this large spectrum of etiologies can cause diagnostic difficulties. Therefore, careful analysis is needed to ensure correct and prompt diagnosis and to avoid any dangerous delays in management.",
    "authors": [
        {
            "affiliation": "Service de neurochirurgie, CHU Lariboisi\u00e8re, 2, rue Ambroise-Par\u00e9, 75475 Paris cedex 10, France. Electronic address: bertrand.mathon@neurochirurgie.fr.",
            "firstname": "B",
            "initials": "B",
            "lastname": "Mathon"
        },
        {
            "affiliation": "Service de neurologie, CHU Lariboisi\u00e8re, 2, rue Ambroise-Par\u00e9, 75475 Paris cedex 10, France.",
            "firstname": "A",
            "initials": "A",
            "lastname": "Ducros"
        },
        {
            "affiliation": "Service de neurochirurgie, CHU Lariboisi\u00e8re, 2, rue Ambroise-Par\u00e9, 75475 Paris cedex 10, France.",
            "firstname": "D",
            "initials": "D",
            "lastname": "Bresson"
        },
        {
            "affiliation": "Service de neurochirurgie, CHU Lariboisi\u00e8re, 2, rue Ambroise-Par\u00e9, 75475 Paris cedex 10, France.",
            "firstname": "A",
            "initials": "A",
            "lastname": "Herbrecht"
        },
        {
            "affiliation": "Service de neurochirurgie, CHU Lariboisi\u00e8re, 2, rue Ambroise-Par\u00e9, 75475 Paris cedex 10, France.",
            "firstname": "G",
            "initials": "G",
            "lastname": "Mirone"
        },
        {
            "affiliation": "Service de neuroradiologie interventionnelle, CHU Lariboisi\u00e8re, 2, rue Ambroise-Par\u00e9, 75475 Paris cedex 10, France.",
            "firstname": "E",
            "initials": "E",
            "lastname": "Houdart"
        },
        {
            "affiliation": "Service de neuroradiologie interventionnelle, CHU Lariboisi\u00e8re, 2, rue Ambroise-Par\u00e9, 75475 Paris cedex 10, France.",
            "firstname": "J-P",
            "initials": "JP",
            "lastname": "Saint-Maurice"
        },
        {
            "affiliation": "Service de neurochirurgie, CHU Lariboisi\u00e8re, 2, rue Ambroise-Par\u00e9, 75475 Paris cedex 10, France.",
            "firstname": "P",
            "initials": "P",
            "lastname": "Di Emidio"
        },
        {
            "affiliation": "Service de neurochirurgie, CHU Lariboisi\u00e8re, 2, rue Ambroise-Par\u00e9, 75475 Paris cedex 10, France.",
            "firstname": "B",
            "initials": "B",
            "lastname": "George"
        },
        {
            "affiliation": "Service de neurochirurgie, CHU Lariboisi\u00e8re, 2, rue Ambroise-Par\u00e9, 75475 Paris cedex 10, France.",
            "firstname": "S",
            "initials": "S",
            "lastname": "Chibbaro"
        }
    ],
    "conclusions": "The three most common causes in this series were RCVS, followed by CVST and bleeding from MA. Because of atypical clinical or radiological presentations, this large spectrum of etiologies can cause diagnostic difficulties. Therefore, careful analysis is needed to ensure correct and prompt diagnosis and to avoid any dangerous delays in management.",
    "copyrights": "Copyright \u00a9 2013 Elsevier Masson SAS. All rights reserved.",
    "doi": "10.1016/j.neurol.2013.07.032",
    "journal": "Revue neurologique",
    "keywords": [
        "An\u00e9vrysme mycotique",
        "Cerebral sinus thrombosis",
        "Cerebral venous thrombosis",
        "H\u00e9morragie intrac\u00e9r\u00e9brale",
        "H\u00e9morragie m\u00e9ning\u00e9e",
        "Intra-cerebral hemorrhage",
        "Mycotic aneurysm",
        "Reversible cerebral vasoconstriction syndrome",
        "Subarachnoid hemorrhage",
        "Syndrome de vasoconstriction c\u00e9r\u00e9brale r\u00e9versible",
        "Thrombophl\u00e9bite c\u00e9r\u00e9brale",
        "Thrombose veineuse c\u00e9r\u00e9brale",
        "Vasospasm",
        "Vasospasme"
    ],
    "methods": null,
    "publication_date": "2014-01-15",
    "pubmed_id": "24411684",
    "results": "RCVS appeared spontaneously in 16 patients and was related to the postpartum period in three cases. Subarachnoid hemorrhage (SAH) was demonstrated in 24 patients as follows: 18 cases were in cortical areas, 4 were in the polygon of Willis, one was inter-hemispheric, and one was inter-hemispheric/intra-cerebral. A convexity pure intra-cerebral hemorrhage (ICH) was recorded in 6 cases. Among the 7 patients suffering from CVST, the superior sagittal sinus was involved in 4 cases, the transverse sinuses (TS) in 2, and the TS plus sigmoid sinus (SS) in one.",
    "title": "Subarachnoid and intra-cerebral hemorrhage in young adults: rare and underdiagnosed.",
    "xml": "<Element 'PubmedArticle' at 0x788505b7d6c0>"
}