What Does "subarachnoid Hemorrhage In The Left Sylain Fissure" Mean?

Posted on Mon, 2 Jun 2014

Question: Hello Doctor, This is follow up to the previous query and I apologize that I have not respond back to your answer.

as per neurologist, my mother had MRI scan today and I am attaching same MRI report here for your reference. after looking at the report neurologist recommended my mother to undergo angiogram test to know more details on this problem.

MRI Report Result:

IMPRESSION:
SUBARACHNOID HEMORRHAGE IN THE LEFT SYLAIN FISSURE AND LEFT FRONTAL CORTICAL SULCI

MR ANGIOGRAM REVEALS IRREGULARITY OF THE LEFT MCA AT THE BIFURCATION LEVEL WITH SUSPICIOUS TINY OUPOUCHING -? RUPTURED ANEURYSM

Could you kindly provide me your opinion (or view) on this MRI report and let us know what is going on with my mother and what would be your advice and suggestion for our further steps.

Is this problem is something very serious to treat? and what would be the treatment for this?

I would appreciate your valuable response on this.

Answered by Dr. Sudhir Kumar (6 hours later)

Brief Answer:
Angiogram is needed to confirm the diagnosis.

Detailed Answer:
Hi,

Thank you for getting back with your mother's MRI and MR angiogram report.

The report shows bleeding in the brain on the left side. There is a suspicion of an aneurysm (a balloon like dilatation from the blood vessel). This can be confirmed by doing a conventional angiogram (by injecting dye).

Treatment of an aneurysm would be either by clipping (surgery) or coiling (without surgery-through angiogram route) of the aneurysm.

The condition is serious but responds well to treatment.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad, India
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Sudhir Kumar (20 hours later)

Hello Dr, Thank you very much for your valuable response.

I do have some queries they are:

1. On what basis neurologist or neurosurgeon will decide the method of treatment? On the size of aneurysm?

2. If surgeon decides Coiling treatment, will it be done along with angiography or this treatment will be done separately?

3. My mother had MRI scan at my native place which is small town, and she will be taking angiography in Manipal Hospital, Bangalore, will she have an another MRI Scan before angiography?

4. She is a low spirit and very anxious person with respect to medical treatment and her BP goes high easily like 150, so please advice us how to provide moral support and help her overcome this.

Answered by Dr. Sudhir Kumar (11 hours later)

Brief Answer:
She needs to get psychological support.

Detailed Answer:
Thank you for getting back with more queries. Here are my replies:

1. The decision regarding the method of treatment depends on the size of aneurysm as well as location of aneurysm.

2. The treatment will require another session. The current angiography is only for confirmation of diagnosis.

3. MRI would not be repeated at Manipal Hospital.

4. We need to provide her moral and psychological support and convince her that this condition is fully treatable.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar