{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T18:17:27Z","timestamp":1762021047847,"version":"build-2065373602"},"reference-count":10,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground:<\/jats:title>\nElectrocardiography (ECG) changes after subarachnoid hemorrhage (SAH) are well described. However, concurrent myocardial infarction (MI) and SAH are rarely reported, and its management remains a dilemma. We report a patient with traumatic SAH concurrent with acute MI that managed successfully by endovascular intervention and dual antiplatelet therapy.<\/jats:p>\n<\/jats:sec>\n\nCase Description:<\/jats:title>\nA 47-year-old man was admitted to the emergency department with a complaint of severe headache. Diffuse SAH, with a Hunt and Hess score of 5, was noticed. ECG showed ST elevation in anterior leads, and cardiac troponin became positive. On brain computed tomography angiogram, a 6 mm anterior communicating artery aneurysm was seen. Considering the possibility of MI and SAH simultaneously, endovascular obliteration of the aneurysm was done, and then, the patient received dual antiplatelet medications until coronary angiography was done. Coronary angiography revealed normal epicardial coronary arteries. The patient was discharged with a Glasgow Coma Scale score of 15 and was visited 2 months after discharge without any new episodes of intracranial hemorrhage with a modified Rankin scale score of 2.<\/jats:p>\n<\/jats:sec>\n\nConclusion:<\/jats:title>\nCerebral aneurysm coiling could be considered as the first choice of treatment in the case of acute MI with hemodynamic stability, before carrying out cardiac endovascular intervention or antiplatelet medication to reduce the risk of rebleeding from a brain aneurysm.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_472_2019","type":"journal-article","created":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T09:46:19Z","timestamp":1584697579000},"page":"49","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Dual antiplatelet therapy in a patient with simultaneous aneurysmal subarachnoid hemorrhage and myocardial infarction"],"prefix":"10.25259","volume":"11","author":[{"given":"Abolghasem","family":"Mortazavi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Sina Hospital, Tehran, Iran."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sina","family":"Jelodar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sina Hospital, Tehran, Iran."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keyvan","family":"Edraki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sina Hospital, Tehran, Iran."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sima","family":"Narimani","sequence":"additional","affiliation":[{"name":"Tehran Heart Center, Department of Interventional Cardiology, Tehran University of Medical Sciences, Tehran, Iran."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Ghorbani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koroush","family":"Karimi-Yarandi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sina Hospital, Tehran, Iran."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sina","family":"Asaadi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2020,3,21]]},"reference":[{"key":"10.25259\/SNI_472_2019\/ref-1","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1007\/s001340051336","article-title":"Subarachnoid hemorrhage and acute myocardial infarction","volume":"26","author":"B\u00e1rcena","year":"2000","journal-title":"Intensive Care Med"},{"key":"10.25259\/SNI_472_2019\/ref-2","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1093\/bja\/67.1.58","article-title":"Cardiac function in aneurysmal subarachnoid haemorrhage: A study of electrocardiographic and echocardiographic abnormalities","volume":"67","author":"Davies","year":"1991","journal-title":"Br J Anaesth"},{"key":"10.25259\/SNI_472_2019\/ref-3","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.4330\/wjc.v6.i10.1067","article-title":"ST-segment elevation: Distinguishing ST elevation myocardial infarction from ST elevation secondary to nonischemic etiologies","volume":"6","author":"Deshpande","year":"2014","journal-title":"World J Cardiol"},{"key":"10.25259\/SNI_472_2019\/ref-4","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s007010050063","article-title":"The use of cardiac troponin-I (cTnI) to determine the incidence of myocardial ischemia and injury in patients with aneurysmal and presumed aneurysmal subarachnoid hemorrhage","volume":"140","author":"Horowitz","year":"1998","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_472_2019\/ref-5","doi-asserted-by":"crossref","first-page":"702","DOI":"10.3171\/2017.5.JNS17831","article-title":"Dual antiplatelet therapy in aneurysmal subarachnoid hemorrhage: Association with reduced risk of clinical vasospasm and delayed cerebral ischemia","volume":"129","author":"Nagahama","year":"2018","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_472_2019\/ref-6","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1054\/jelc.2002.37187","article-title":"Electrocardiographic repolarization abnormalities in subarachnoid hemorrhage","volume":"35","author":"Sommargren","year":"2002","journal-title":"J 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