Perimesenchephalic subarachnoid haemorrhage
Sudden onset of severe headache with neck stiffness following exercise. No reduced consciousness.
Non-contrast CT followed by CT angiogram C of W
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Subarachnoid haemorrhage predominately in the interpeduncular and ambient cisterns extending down into the pre-pontine and perimedullary cisterns especially on the right. No blood above the tentorium. CTA is normal without berry aneurysm or other vascular anomaly.
An important diagnosis as associated with an excellent prognosis. Bleeding thought to be of venous origin from the extensive perimesenchephlic venous plexus.