{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T20:05:31Z","timestamp":1750277131539},"reference-count":20,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>The causes of angiogram-negative subarachnoid hemorrhage (SAH) on initial angiography, which accounts for 10\u201330% of spontaneous SAH, are heterogeneous and still unclear. We report a case of nonaneurysmal SAH, in which initial computed tomographic angiography (CTA) showed no source of bleeding, but the subsequent digital subtraction angiography (DSA) revealed contrast extravasation from the basilar artery without aneurysms.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>A 67-year-old woman with a medical history of hypertension presented as SAH of World Federation of Neurological Surgeons Grade II. CTA on admission did not show any cause of bleeding and DSA was subsequently performed to show contrast extravasation from a perforator of the middle third of the basilar artery without aneurysms during the subsequent DSA, resulting in profound deterioration SAH and neurological status. The patient was conservatively treated. Follow-up DSAs on days 2 and 16 showed no source of bleeding as well.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Although the precise cause of bleeding in this case is uncertain, SAH might be caused by local dissection of the basilar artery perforator, and the bleeding site might heal spontaneously without forming of a pseudoaneurysm.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_713_2021","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T22:12:31Z","timestamp":1633644751000},"page":"498","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Contrast extravasation from basilar artery without aneurysm formation on digital subtraction angiography in computed tomography angiogram-negative subarachnoid hemorrhage: A case report"],"prefix":"10.25259","volume":"12","author":[{"given":"Hideki","family":"Nakajima","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Suzuka General Hospital, Suzuka,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuro","family":"Tsuchiya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Suzuka General Hospital, Suzuka,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigetoshi","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Suzuka General Hospital, Suzuka,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidenori","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2021,10,6]]},"reference":[{"key":"10.25259\/SNI_713_2021\/ref-1","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1136\/neurintsurg-2019-015375","article-title":"Digital subtraction cerebral angiography after negative computed tomography angiography findings in non-traumatic subarachnoid hemorrhage","volume":"12","author":"Catapano","year":"2020","journal-title":"J Neurointerv Surg"},{"key":"10.25259\/SNI_713_2021\/ref-2","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.3171\/2014.7.JNS132411","article-title":"Spontaneous resolution of perforator aneurysms of the posterior circulation","volume":"121","author":"Chavent","year":"2014","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_713_2021\/ref-3","doi-asserted-by":"crossref","first-page":"20","DOI":"10.7461\/jcen.2015.17.1.20","article-title":"Contrast extravasation on computed tomography angiography imitating a basilar artery trunk aneurysm in subsequent conventional angiogram-negative subarachnoid hemorrhage: Report of two cases with different clinical courses","volume":"17","author":"Cho","year":"2015","journal-title":"J Cerebrovasc Endovasc Neurosurg"},{"key":"10.25259\/SNI_713_2021\/ref-4","doi-asserted-by":"crossref","first-page":"93","DOI":"10.2176\/nmccrj.cr.2019-0143","article-title":"Ruptured basilar artery perforator aneurysm: A case report and review of the literature","volume":"7","author":"Enomoto","year":"2020","journal-title":"NMC Case Rep J"},{"key":"10.25259\/SNI_713_2021\/ref-5","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.jstrokecerebrovasdis.2005.07.004","article-title":"Perimesencephalic subarachnoid hemorrhage: Incidence, risk factors, and outcome","volume":"14","author":"Flaherty","year":"2005","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"10.25259\/SNI_713_2021\/ref-6","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1097\/00006123-199608000-00034","article-title":"Distal basilar perforator artery aneurysm: Case report","volume":"39","author":"Ghogowala","year":"1996","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_713_2021\/ref-7","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1016\/j.crad.2005.06.007","article-title":"Computed tomography angiography for the detection and characterization of intra-cranial aneurysms: Current status","volume":"60","author":"Goddard","year":"2005","journal-title":"Clin Radiol"},{"key":"10.25259\/SNI_713_2021\/ref-8","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.clineuro.2003.09.002","article-title":"\u201cOccult\u201d ruptured cerebral aneurysms revealed by repeat angiography: Result from a large retrospective study","volume":"106","author":"Inamasu","year":"2003","journal-title":"Clin Neurol Neurosurg"},{"key":"10.25259\/SNI_713_2021\/ref-9","doi-asserted-by":"crossref","first-page":"8","DOI":"10.2298\/SARH1202008K","article-title":"Complications after angiogram-negative subarachnoid haemorrhage: Comparative study of pretruncal and nonpretruncal hemorrhage patients","volume":"140","author":"Kosti\u0107","year":"2012","journal-title":"Srp Arh Celok Lek"},{"key":"10.25259\/SNI_713_2021\/ref-10","doi-asserted-by":"crossref","first-page":"203","DOI":"10.5811\/westjem.2019.1.37352","article-title":"Approach to the diagnosis and management of subarachnoid hemorrhage","volume":"20","author":"Marcolini","year":"2019","journal-title":"West J Emerg Med"},{"key":"10.25259\/SNI_713_2021\/ref-11","first-page":"80","article-title":"The surgical anatomy of the perforating branches of the basilar artery","volume":"33","author":"Marinkovi\u0107","year":"1993","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_713_2021\/ref-12","doi-asserted-by":"crossref","first-page":"859","DOI":"10.3171\/jns.2000.93.5.0859","article-title":"Arterial dissections of penetrating cerebral arteries causing hypertension-induced cerebral hemorrhage","volume":"93","author":"Mizutani","year":"2000","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_713_2021\/ref-13","doi-asserted-by":"crossref","first-page":"2013","DOI":"10.1007\/s00701-019-04025-w","article-title":"Subarachnoid haemorrhage with negative initial neurovascular imaging: A systematic review and meta-analysis","volume":"161","author":"Mohan","year":"2019","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_713_2021\/ref-14","first-page":"829","article-title":"Nonaneurysmal perimesencephalic subarachnoid hemorrhage: CT and MR patterns that differ from aneurysmal rupture","volume":"12","author":"Rinkel","year":"1991","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.25259\/SNI_713_2021\/ref-15","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/BF01541778","article-title":"Subarachnoid haemorrhage of unknown aetiology","volume":"119","author":"Ronkainen","year":"1992","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_713_2021\/ref-16","first-page":"433","article-title":"Perimesencephalic nonaneurysmal subarachnoid hemorrhage: Review of the literature","volume":"39","author":"Schwartz","year":"1996","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_713_2021\/ref-17","doi-asserted-by":"crossref","first-page":"E1047","DOI":"10.1227\/NEU.0b013e318268fecb","article-title":"Contrast extravasation on computed tomographic angiography mimicking a basilar artery aneurysm in angiogram-negative subarachnoid hemorrhage: Report of 2 cases","volume":"71","author":"Stetson","year":"2012","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_713_2021\/ref-18","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1136\/neurintsurg-2011-010025","article-title":"Computed tomographic angiography versus digital subtraction angiography for the postoperative detection of residual aneurysms: A single-institution series and meta-analysis","volume":"4","author":"Thaker","year":"2012","journal-title":"J Neurointerv Surg"},{"key":"10.25259\/SNI_713_2021\/ref-19","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/j.jstrokecerebrovasdis.2014.11.011","article-title":"Diffuse patterns of nonaneurysmal subarachnoid hemorrhage originating from the basal cisterns have predictable vasospasm rates similar to aneurysmal subarachnoid hemorrhage","volume":"24","author":"Walcott","year":"2015","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"10.25259\/SNI_713_2021\/ref-20","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1017\/cjn.2018.75","article-title":"Digital subtraction angiography for CT angiogram negative hemorrhages","volume":"45","author":"Wong","year":"2018","journal-title":"Can J Neurol Sci"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/contrast-extravasation-from-basilar-artery-without-aneurysm-formation-on-digital-subtraction-angiography-in-computed-tomography-angiogram-negative-subarachnoid-hemorrhage-a-case-report\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/contrast-extravasation-from-basilar-artery-without-aneurysm-formation-on-digital-subtraction-angiography-in-computed-tomography-angiogram-negative-subarachnoid-hemorrhage-a-case-report\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T22:12:53Z","timestamp":1633644773000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/contrast-extravasation-from-basilar-artery-without-aneurysm-formation-on-digital-subtraction-angiography-in-computed-tomography-angiogram-negative-subarachnoid-hemorrhage-a-case-report\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,6]]},"references-count":20,"alternative-id":["10.25259\/SNI_713_2021"],"URL":"https:\/\/doi.org\/10.25259\/sni_713_2021","relation":{},"ISSN":["2152-7806"],"issn-type":[{"value":"2152-7806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,6]]},"article-number":"498"}}