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Subarachnoid hemorrhage

Case contributed by Ahmed Abdrabou
Diagnosis certain

Presentation

Severe headache and recurrent vomiting of 3 days duration

Patient Data

Age: 58 years old
Gender: Male
mri

Hyperintense fluid in all pulse sequences seen filling and expanding the left sylvian fissure and adjacent sulci.

A small middle cerebral artery saccular aneurysm is identified in post contrast study.

Diagnosis: Subarachnoid hemorrhage due to rupture aneurysm

Case Discussion

Differentials for hyperintensity at subarachnoid space includes

  • fat droplet in rupture dermoid cyst.
  • hemorrhage in subarachnoid hemorrhage (SAH)
  • meningitis and meningeal carcinomatosis

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