Lobar intracerebral hemorrhages (ICHs) involve the white matter of the cerebral lobes, and originate at the corticosubcortical gray matter-white matter junctions. Lobar hemorrhages are distinct from other forms of ICH in their clinical presentation, causes, prognosis, and management. Lobar hemorrhage has been thought to have a better prognosis than the deep hemispheric (putaminal, thalamic) and posterior fossa hemorrhages. The case fatality rates reported have ranged between 11% and 32%, in comparison with 42% for basal ganglionic and thalamic ICH, and 43% for posterior fossa hemorrhages. The observed differences in case fatality between lobar and deep ICH probably reflect variations in hematoma size and mass effect more than their superficial versus deep location. The value of medical and surgical therapy for lobar ICH will ultimately have to be determined by clinical trials involving randomization of comparable groups of patients to one or the other type of treatment.

Stroke syndromes: Spinal stroke syndromes

A 60-year-old man who had had transarterial embolization six times for multiple hepatocellular carcinoma received seventh transarterial embolization at the hospital. Procedures included that 4mg of smankus was dissolved in 10ml of lipiodol, and 5. 3, and 1ml of the solustion were infused into the right inferior dia-phragmatic artery and right posterior intracostal artery (between the 9th and 10th) which fed the tumor. The patient complained of numbness and pain of the bilateral lower extremities immediately after the infusion. On the next day the patient manifested symptoms of transverse lesion of spinal cord which did not recover hereafter. Magnetic resonance imaging revealed an infarction image at the level of Th 9/10. Reevaluation of an angiography which was taken before surgery showed spinal artery branched from the 9th posterior intercostal artery. Thus, it was thought that lipiodol flew into the spinal artery through intracostal artery causing spinal infarction.

Infusion of lipiodol into the posterior intercostal artery causing spinal infarction-a case report-

Spinal cord ischemia complicating hepatic artery chemoembolization in a patient with prior hemihepatectomy

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Spinal cord ischemia complicating hepatic artery chemoembolization in a patient with prior hemihepatectomy