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Stroke

Ischemia

12/10/2007

Question:

Is it common to have ischemia prior to SAH? My Wife experienced ischemia in the left opercular region that was several days later infarct, this ischemia was noted when she was admitted to the hospital for SAH. The ischemia I was told was present for at least 24 hours prior to the admission... she was a healthy non smoking not overweight 35 year old taking no other meds except... vioxx Thank you for your comments.

Answer:

It is not typical to have an ischemic infarct prior to SAH. It is common to have SAH, then have vasospasm (where the blood in the subarachnoid space irritates the blood vessels, causing them to go into spasm and close down) which can lead to ischemia. So it is possible that there was some SAH that came first, followed by vasospasm and infarct, and then come to medical attention (with the possibility of a re-bleed from the source of the SAH, which is typically an aneurysm).

Beyond these general comments, I cannot provide more information since I do not have the advantage of taking a full medical history and doing a full physical examination. I suggest that you ask these same questions of your local physicians who know you best.

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Response by:

Brett   Kissela, MD Brett Kissela, MD
Assistant Professor of Neurology
Director, Neurology Residency Program
College of Medicine
University of Cincinnati