Keywords
Osteogenesis imperfecta; Aneurysmal Subarachnoid hemorrhage; Vasospasm; Milrinone
Abstract
Background: Osteogenesis Imperfecta (OI) is a rare inherited collagen disease of variable severity. Our patient was diagnosed with OI prior to aneurysmal Subarachnoid Hemorrhage (aSAH) occurrence. To our knowledge, this is the first case report of an OI patient with SAH associated vasospasm treated with milrinone.
Case Presentation: A 35 year old female - known for OI - was brought to the Neuro-critical care unit after being intubated for generalized tonic-clonic seizure. A CT/CTA of the brain revealed acute aSAH due to basilar artery aneurysmal rupture, with early hydrocephalus. An External Ventricular Drain (EVD) was installed and the aneurysm was coiled the next day. Two days later her Glasgow Comma Scale (GCS) was back to 15/15. Ten Days post aSAH she became obtunded, with right arm weakness. Transcranial Doppler confirmed the diagnosis of vasospasm. She received IV Mi-lrinone and regained her level of consciousness and power. Her modified Rankin Score (mRS) was 1 at time of discharge and 0 three months later. To our knowledge, this is the first case report of OI treated (successfully) using IV milrinone for cerebral vasospasm after aSAH.
Conclusion: Cerebral vasospasm after aSAH has been known to occur in OI. Here we present a patient with OI who developed vasospasm related deficit that responded well to IV Milrinone, with good outcome based on mRS
Citation
Alamri A, Alsodairi G, Alturki A, Badawy M, Cortés M and Teitelbaum J. Osteogenesis Imperfecta Presented with Aneurysmal Subarachnoid Hemorrhage, Complicated by Vasospasm and Treated with Intravenous Milrinone. SM J Neurol Disord Stroke. 2016; 2(1): 1007.