Pseudo-subarachnoid haemorrhage

Case contributed by Dr Fakhry Mahmoud Ebouda

Presentation

Post cardiac arrest with fixed pupil.

Patient Data

Age: 4 years
Gender: Female

Significant generalized low attenuation of the entire brain parenchyma and cerebellum with marked effacement of the brain sulci as well as major cisterns. Associated hyper-density is noted within giving the appearance of pseudo-subarachnoid hemorrhage.Gray-white matter interface has been lost. Attenuated ventricular system with no midline shift with evidence of tonsiller cerebral herniation.

Case Discussion

A typical case of pseudo-subarachnoid hemorrhage in a young person with post cardiac arrest with resultant hyoxic cerebral insult. Consequent diffuse brain edema and swelling where there is global decrease in parenchymal attenuation. An associated increased intracranial pressure results in engorgement and dilatation of the superficial venous structures of the basal meninges yet no blood seen in the ventricles or sulci all over the vertex of the brain.

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Case information

rID: 57669
Published: 5th Jan 2018
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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