CASE REPORT
A hemorragia subaracnoidea perimesencefálica não aneurismática é um tipo relativamente raro de sangramento subaracnoideo espontâneo, definido pelo acúmulo de sangue em topografias específicas do sistema nervoso central, a saber, cisternas da base (interpeduncular, crural, ambiens e quadrigêmea) podendo se estender para parte posterior da fissura inter-hemisférica anterior e parte basal da fissura sylviana, não associados a sangramento intraventricular franco ou hematoma intraparenquimatoso. É uma condiçãoclínica de curso benigno, mostrando melhor prognóstico que sangramento aneurismático sendo, na maioria das vezes, tratamento conservador. O presente artigo visa descrever o relato de um caso com características de uma hemorragia perimesencefálica na evolução pós-operatória de um adenoma hipofisário não produtor, abordado por via endoscópica assim como revisar epidemiologia, diagnóstico, prognóstico e considerações na literatura sobre a patologia hemorrágica.
Non-aneurysmal perimesencephalic subarachnoid hemorrhage is a relatively rare type of spontaneous subarachnoid bleeding defined by the accumulation of blood in specific topographies of the central nervous system, namely basal cisterns (interpeduncular, crural, ambient and quadrigeminal), which may extend to the posterior part of the fissure. anterior interhemispheric artery and basal part of the sylvian fissure, not associated with frank intraventricular bleeding or intraparenchymal hematoma. It is a clinical condition with benign course, with better prognosis than aneurysmal bleeding and being most often conservative treatment. This article aims to describe a case report with characteristics of a perimesencephalic hemorrhage in the postoperative evolution of a non-producing pituitary adenoma, approached endoscopically, as well as to review epidemiology, diagnosis, prognosis and considerations in the literature on the hemorrhagic pathology.
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1 MD, MR, Neurosurgery Service, São Marcos Hospital, Associação Piauiense de Combate ao Câncer – APCC, Teresina, PI, Brazil.
2 MD, MR, Neurosurgery Department, Getúlio Vargas Hospital – HGV, Teresina, PI, Brazil.
3 MD, Otorhinolaryngology Department, Getúlio Vargas Hospital – HGV, Teresina, PI, Brazil.
4 MD, PhD, Neurosurgeon, Adjunct professor, School of Medical Sciences – FACIME, State University of Piauí – UESPI, Teresina, PI, Brazil.
5 MD, MSc., Neurosurgeon, Federal University of Piaui, Teresina, PI, Brazil.
6 MD, MSc., Neurosurgeon, Getulio Vargas Hospital – HGV, Teresina, PI, Brazil.
Received Sep 28, 2023
Accepted Oct 3, 2023
