Pseudo-subarachnoid haemorrhage

Case contributed by Dr Andrew Dixon

Presentation

Patient comatose on arrival in the emergency department following a cardiac arrest with prolonged downtime at the scene.

Patient Data

Age: 55
Gender: Female
Modality: CT

Generalised cerebral oedema. The basal cisterns appear dense (pseudo-subarachnoid haemorrhage) likely due to combination of cistern effacement, possible thrombus within intracranial vessels and surrounding relatively low attenuating brain.

Case Discussion

Non-contrast CT Brain shows generalised sulcal effacement and cerebral hypoattenuation with loss of grey-white differentiation consistent with cerebral oedema secondary to intracranial hypoxia. The basal cisterns appear dense  likely due to combination of cistern effacement, possible thrombus within intracranial vessels and surrounding relatively low attenuating brain. This appearance has been termed pseudo-subarachnoid haemorrhage. Brain death was subsequently confirmed with nuclear medicine cerebral perfusion scan. 

PlayAdd to Share

Case Information

rID: 9345
Case created: 7th Apr 2010
Last edited: 6th Dec 2016
Tag: brain
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.