Cerebral vasospasm following subarachnoid hemorrhage

Case contributed by Maxime St-Amant
Diagnosis almost certain

Presentation

Follow-up of extensive subarachnoid hemorrhage.

Patient Data

Age: 30 years
Gender: Female

Multifocal vasospasms (MCA, ACA, SCA, PCA) related to extensive subarachnoid hemorrhage are well depicted on these 3D reformats. There is narrowing of these arteries near the bifurcation giving the impression of enlargement of said bifurcation.

Severe narrowing of the proximal ACAs with narrowing of the proximal M2 and distal M1 of the right MCA. This gives a slightly enlarged appearance to the right MCA bifurcation, typical of vasospasm.

Narrowing at the origin of the SCAs and PCAs related to vasospasm also give an enlarged appearance to the distalmost basilar artery. There is also diffuse narrowing of the basilar artery.

Case Discussion

These are typical findings of vasospasm following subarachnoid hemorrhage. This appearance may help to differentiate the etiology of the narrowing from that vasculitis.

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