Learning objectives
Peripheral convexal SAH is an increasingly recognised form of non-aneurysmal SAH in which haemorrhage is localised to the sulci of the cerebral convexities without involvement of the basal cisterns,
sylvian fissure or ventricles.The purpose of this poster is to illustrate the key clinical and radiological imaging features identified in the various aetiologies of convexal SAH.
Background
Subarachnoid haemorrhage (SAH) occurs in a wide variety of clinical settings and can be classified into distinct imaging patterns based on haemorrhage location.
In peripheral convexal SAH,
haemorrhage is localised to the sulci of the cerebral convexities without involvement of the basal cisterns,
sylvian fissure or ventricles [1].
Convexal SAH has a broad spectrum of aetiologies which includes trauma,
cerebral amyloid angiopathy (CAA) and reversible cerebral vasoconstriction syndrome (RCVS)[2,3].
The diagnosis and identification of the underlying causative disorder in this condition may be under-recognised and...
Findings and procedure details
Clinical Features
The clinical presentation of convexal SAH varies depending on the location of haemorrhage as well as the the underlying aetiology.
The onset of symptoms can be sudden or gradual and patients may present with one or multiple neurological features which can be transient in nature.
Common presenting symptoms include:
Headache: Thunderclap or gradual onset
Altered mental status
Sensorimotor symptoms: Weakness,
numbness,
dysarthria or aphasia
Seizure: Partial or generalised
Clinical features vary depending on patient age.
Cerebral amyloid angiopathy (CAA) is the most common...
Conclusion
Brain imaging of convexal SAH is illustrated.
The key radiological findings associated with the various aetiologies of this condition are described.
This educational poster demonstrates a systematic approach to the diagnosis of convexal SAH and describes the specific imaging findings of the numerous aetiologies of this condition.
Personal information
Dr Adam Roche
Email:
[email protected]
Department of Radiology,
Division of Neuroradiology,
Beaumont Hospital,
Beaumont Road,
Dublin 9,
Ireland
References
Marder CP,
Narla V,
Fink JR at al.
Subarachnoid haemorrhage: beyond aneurysms.
Am J Roentgenol 2014;202(1):25-37
Mangla R,
Drumsta D,
Alamst J et al.
Cerebral convexity subarachnoid haemorrhage: various causes and role of diagnostic imaging.
Emerg Radiol 2015;22(2):181-195
Khurram A,
Kleinig T,
Leyden J.
Clinical associations and causes of convexity subarachnoid haemorrhage.
Stroke 2014;45(4):1151-1153