Perimesencephalic subarachnoid hemorrhage

Case contributed by Assoc Prof Frank Gaillard

Presentation

Sudden onset of headache. No loss of consciousness or neurological deficit.

Patient Data

Age: 45 years
Gender: Male

CT brain

CT

Blood is seen in the perimesencephalic cistern. 

Case Discussion

This is the typical distribution of perimesencephalic subarachnoid hemorrhage, which usually is non-aneurysmal in origin. 

This patient went on to have a CTA which demonstrated no evidence of an aneurysm. They were further evaluated with DSA and followup and he has remained well. 

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