Learning objectives
- To present a serie of cases of atypical subarachnoid hemorrhages (SAH): pseudotumor cerebrii,
reversible vasoconstriction syndrome,
dural venous sinus thrombosis and cortical vein thrombosis.
- To describe the imaging features of the different causes in isolated acute non-traumatic cortical subarachnoid hemorrhage.
- To illustrate the appropriate diagnostic-therapeutic management of this entity.
Background
CAUSES OF SAH
Although trauma is the most common cause of SAH,
ruptured saccular aneurysms are the most common cause of nontraumatic SAH,
accounting for approximately 85% of cases of spontaneous SAH.
Of the remaining 15% of cases,
two thirds are due to idiopathic perimesencephalic hemorrhage,
a benign non-aneurysmal form of SAH that is likely venous in origin.
The remaining cases result from a wide variety of causes.
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PATTERNS OF BLOOD DISTRIBUTION
SAH can be classified into at least three distinct patterns by location...
Findings and procedure details
CEREBRAL VENOUS THROMBOSIS
REVERSIBLE CEREBRAL VASOCONSTRICTION SYNDROME
IDIOPATHIC INTRACRANIAL HYPERTENSION
Conclusion
The HSA in convexities,
without a traumatic antecedent and without associating the characteristic aneurysmatic or peri-mesencephalic localization,
makes it necessary to rule out atypical entities,
since the adequate diagnosis radically changes the therapeutic approach and the prognosis of the patient,
with the reduction of the morbidity and mortality that this entails.