Presentation
Worsening headache
Patient Data
Age: 60 years
Gender: Male
From the case:
Non-aneurysmal perimesencephalic subarachnoid hemorrhage
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Non-contrast study demonstrates subarachnoid hemorrhage anterior to the midbrain and surrounding the basilar artery and along the left vertebral artery, characteristic of nonaneurysmal perimesencephalic hemorrhage. No extension to convexities or ventricular system. CT angiography is normal with no evidence of aneurysm.
Case Discussion
Commonly, cases of non-traumatic subarachnoid hemorrhage are caused by aneurysm rupture. However, a small category of patients with subarachnoid hemorrhage (SAH) will have no identifiable cause on CT angiography (CTA).
These categories of patients with CTA-negative SAH demonstrate a pattern known as non-aneurysmal perimesencephalic subarachnoid hemorrhage.
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