Presentation
Sudden onset of headache and collapse.
Patient Data
Extensive subarachnoid blood is demonstrated not only around the circle of Willis but also extending up into both Sylvian fissures, inter-hemispheric fissure anteriorly and over the convexities. In addition, blood has filled the pre-pontine and cerebellopontine cisterns and refluxed into the ventricular system, with some blood pooling in the occipital horns of the lateral ventricles. Hydrocephalus is present.
In addition to blood seen in all the basal cisterns and over the cerebral convexities, it has also refluxed into the ventricular system, visible filling the fourth ventricle (blue arrow) and pooling in the occipital horns (red arrows). The ventricles are distended, most easily appreciated in the temporal horns (yellow arrow).
Case Discussion
This case demonstrates typical appearances of extensive spontaneous subarachnoid hemorrhage with extension into the ventricles and resulting hydrocephalus.
The patient went on to have an aneurysm identified and coiled, and required placement of an external ventricular catheter for management of hydrocephalus.
Unable to process the form. Check for errors and try again.