Work

Benign versus sinister aetiologies underlying basal cistern subarachnoid haemorrhage: a case series

Year: 2025

Type: article

Abstract: BACKGROUND: Subarachnoid hemorrhage in the basal cisterns is usually identified on an unenhanced computed tomography scan of the head in patients presenting acutely with a characteristic sudden onset headache. CASE PRESENTATION: Using imaging examples from our tertiary neurosciences center, we present six cases demonstrating a variety of causes for subarachnoid hemorrhage in the basal cisterns, ranging from benign to sinister causes. These include a venous perimesencephalic hemorrhage (35 years, female), pontine perforator aneurysm (54 years, male), vertebral artery dissection (69 years, male), cervical dural arteriovenous fistula (65 years, male), posterior fossa arteriovenous malformation (45 years, male), and vertebral artery aneurysm (78 years, female). Ethnically, all these patients were white. Specific imaging features are described and demonstrated. CONCLUSION: A balance between avoiding excessive investigation and overlooking what may be a mimic of a venous perimesencephalic hemorrhage is important. To refine and establish more definitive indications on when to perform computed tomography angiogram, digital subtraction angiography, delayed angiography and magnetic resonance imaging in this context requires future research to focus on large-scale prospective multicenter studies with robust data.

Source: Journal of Medical Case Reports

DOI: 10.1186/s13256-024-04950-0

Authors: Gilbert Gravino, Nasr Abdelsalam, Jay Patel, Saad Aamir, Feyi Babatola, Arun Chandran

Institutions: Walton Centre, Keele University

Language: English

Topic: Intracranial Aneurysms: Treatment and Complications

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,890