Pseudo-subarachnoid hemorrhage

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
CT

Generalized cerebral edema. The basal cisterns appear dense (pseudo-subarachnoid hemorrhage) 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 generalized sulcal effacement and cerebral hypoattenuation with loss of grey-white differentiation consistent with cerebral edema 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 hemorrhage. Brain death was subsequently confirmed with nuclear medicine cerebral perfusion scan. 

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Case information

rID: 9345
Published: 7th Apr 2010
Last edited: 6th Nov 2018
Inclusion in quiz mode: Included

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