Subarachnoid haemorrhage

Case contributed by Dr Jeremy Jones

Presentation

Sudden onset of headache and collapse.

Patient Data

Age: 55 years
Gender: Female
CT

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. 

Annotated image

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 haemorrhage 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. 

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Case information

rID: 8808
Case created: 1st Mar 2010
Last edited: 24th Oct 2015
Inclusion in quiz mode: Included

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