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Perimesencephalic haemorrhage

A perimesencephalic haemorrhage is a distinct type of subarachnoid haemorrhage confined to the basal cisterns around the midbrain (typically the interpeduncular and prepontine cisterns).

95% of cases have a normal cerebral angiogram and the source of bleeding is not identified; the cause is thought to be a venous bleed. In these cases, rebleeding and ischaemia are rare and the prognosis is excellent. The other 5% of cases are due to a vertebrobasilar aneurysm and the prognosis is worse.

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