{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:42:29Z","timestamp":1790840549246,"version":"4.1.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose\u2014<\/jats:title>\n                    <jats:p>We systematically reviewed the literature on epidemiology, risk factors, presumed cause, clinical course, and outcome of perimesencephalic hemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\u2014<\/jats:title>\n                    <jats:p>PubMed, Embase, and the Cochrane Library were searched until March 2016. Quality assessment was done by 2 authors independently. Pooled prevalence ratios and pooled odds ratios with 95% confidence intervals were calculated for data extracted from case\u2013control studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\u2014<\/jats:title>\n                    <jats:p>We included 208 papers. The incidence of perimesencephalic hemorrhage is \u22480.5 per 100.000 person-years, men are more often affected, and no risk factors were confirmed. Two decision analyses both found that a single, high-quality computed tomography angiography is the preferred diagnostic approach. Short-term complications, such as hydrocephalus or cranial nerve palsies, are rare, and usually transient, with the exception of acute symptomatic hydrocephalus necessitating treatment in 3% of patients. Lacunar infarcts in the brain stem were convincingly described in 4 patients only. Fatal rebleeding after installment of anticoagulation in the initial days after the hemorrhage was described in 1 patient. At long-term follow-up, death related to the hemorrhage has not been reported, disability is found in 0% to 6%, and neuropsychological sequelae are suggested.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>A single, high-quality computed tomography angiography is the preferred diagnostic strategy. Short-term complications are rare and often transient. Long-term outcome is excellent with respect to disability and death, but high-quality studies focused at neuropsychological sequelae are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.117.019843","type":"journal-article","created":{"date-parts":[[2018,4,25]],"date-time":"2018-04-25T05:05:13Z","timestamp":1524632713000},"page":"1363-1370","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":84,"title":["Perimesencephalic Hemorrhage"],"prefix":"10.1161","volume":"49","author":[{"given":"Liselore A.","family":"Mensing","sequence":"first","affiliation":[{"name":"From the Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery (L.A.M., M.D.I.V., K.G.L., Y.M.R., A.A., G.J.E.R.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mervyn D.I.","family":"Vergouwen","sequence":"additional","affiliation":[{"name":"From the Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery (L.A.M., M.D.I.V., K.G.L., Y.M.R., A.A., G.J.E.R.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamil G.","family":"Laban","sequence":"additional","affiliation":[{"name":"From the Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery (L.A.M., M.D.I.V., K.G.L., Y.M.R., A.A., G.J.E.R.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ynte M.","family":"Ruigrok","sequence":"additional","affiliation":[{"name":"From the Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery (L.A.M., M.D.I.V., K.G.L., Y.M.R., A.A., G.J.E.R.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitta K.","family":"Velthuis","sequence":"additional","affiliation":[{"name":"Department of Radiology (B.K.V.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ale","family":"Algra","sequence":"additional","affiliation":[{"name":"From the Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery (L.A.M., M.D.I.V., K.G.L., Y.M.R., A.A., G.J.E.R.)"},{"name":"Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel J.E.","family":"Rinkel","sequence":"additional","affiliation":[{"name":"From the Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery (L.A.M., M.D.I.V., K.G.L., Y.M.R., A.A., G.J.E.R.)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","first-page":"829","article-title":"Nonaneurysmal perimesencephalic subarachnoid hemorrhage: CT and MR patterns that differ from aneurysmal rupture.","volume":"12","author":"Rinkel GJ","year":"1991","unstructured":"Rinkel GJ, Wijdicks EF, Vermeulen M, Ramos LM, Tanghe HL, Hasan D, et al.. 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