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All patients presented with severe hemorrhage,poor clinical grade,and intracranial hypertension.Motor deficits developed within 7 days of aneurysm rupture and persisted for a mean duration of 39 days.Angiographic evidence of vasospasm in the anterior cerebral artery(ACA)distribution was documented in all cases,and paraparesis persisted beyond the angiographic resolution of vasospasm.All patients had evidence of frontal lobe dysfunction throughout their postoperative courses,and deep venous thrombosis and pulmonary emboli were common causes of morbidity and mortality.Autopsy data supported regional microvascular ischemia within the ACA distribution as the etiology of these motor deficits.The combination of vasospasm in the ACA distribution and lower extremity weakness associated with cognitive and affective impairment that resolves with time is common in patients with ACoA aneurysms.We propose that this constellation of clinical,radiographic,and pathologic findings be referred to as the"ACoA aneurysm paraparesis syndrome." |
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affect,flat
affective disorders
aneurysm
aneurysm,anterior cerebral
aneurysm,anterior communicating
aneurysm,intracranial
anterior cerebral artery
anterior cerebral artery territory infarction
anterior communicating artery
CAT scan,abnormal
intellectual deficit
leg weakness,bilateral
memory,impairment of
paraparesis
psychological testing
vasospasm,cerebral
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