Traumatic subarachnoid hemorrhage

Case contributed by Dr Ammar Ashraf

Presentation

Loss of consciousness and bleeding from the left ear after falling from a horse.

Patient Data

Age: 25 years
Gender: Male
CT

Brain

Undisplaced fracture of the left temporal bone with an underlying small epidural hematoma.

Hemorrhagic cerebral contusions in the right frontal & temporal lobes.

Mild subarachnoid hemorrhage in high right frontoparietal lobe.

CT

Brain (1 month later)

Follow up CT brain after one month showing complete resolution of subarachnoid hemorrhage and marked interval improvement in hemorrhgaic contusions and epidural hematoma. 

Case Discussion

Trauma is the most common cause of subarachnoid hemorrhage (rage 11-60%). It is seen in one-third of patients with moderate brain injury and is probably related to tearing of veins in subarachnoid space. It is most commonly seen in cerebral sulci (peripheral location) and is associated with contusions, subdural hematoma and other trauma-related findings in nearly all cases. It has a better prognosis than aneurysmal SAH.

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Case information

rID: 72437
Published: 26th Nov 2019
Last edited: 16th Dec 2019
Inclusion in quiz mode: Excluded
Institution: King Abdulaziz Hospital Al Ahsa (MNGHA)

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