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NEUROLOGY 1992;42:1805
© 1992 American Academy of Neurology

Acute hydrocephalus in nonaneurysmal Perimesencephalic hemorrhage

Evidence of CSF block at the tentorial hiatus

G.J.E. Rinkel, MD, E. F.M. Wijdicks, MD, M. Vermeulen, MD, J. Th.J. Tans, MD, D. Hasan, MD and J. van Gijn, MD

University Department of Neurology, Utrecht (Drs. Rinkel, Wijdicks, and van Gijn)
University Department of Neurology, Academic Medical Centre, Amsterdam (Dr. Vermeulen)
Department of Neurology, Westeinde Hospital, The Hague (Dr. Tans)
University Department of Neurology, Rotterdam, The Netherlands (Dr. Hasan).

The acute hydrocephalus in patients with nonaneurys-mal perimesencephalic hemorrhage suggests an extraventricular obstruction of CSF flow. We studied the occurrence of acute hydrocephalus and the site of cisternal blood in 40 consecutive patients with perimesencephalic hemorrhage. In all 11 patients with hydrocephalus, all perimesencephalic cisterns were filled with blood; this occurred in only five of the 29 patients (17%) without hydrocephalus (p < 0.0001). We conclude that in the absence of intraventricular blood, filling of all perimesencephalic cisterns with blood is a necessary factor for the development of acute hydrocephalus.

Address correspondence and reprint requests to Dr. Gabriel J.E. Rinkel, University Department of Neurology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.

Received December 6, 1991. Accepted for publication in final form February 11, 1992.




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