Pseudo-subarachnoid Hemorrhage. A Case Report

Authors

  • Elkin José Beltrán Carrascal Hospital Universidad del Norte, Barranquilla, Colombia.
  • David Cianci Bonet Hospital Universidad del Norte, Barranquilla, Colombia.
  • Laura López Brokate Hospital Universidad del Norte, Barranquilla, Colombia.
  • Mauro Duván Mendoza Quevedo Hospital Universidad del Norte, Barranquilla, Colombia.
  • David Francisco Saavedra Segura Hospital Universidad del Norte, Barranquilla, Colombia.
  • Arturo José Viera Oliveros Hospital Universidad del Norte, Barranquilla, Colombia.

DOI:

https://doi.org/10.53903/01212095.6

Keywords:

Subarachnoid hemorrhage, Tomography, X-ray computed, Hypoxia, brain, Cryptococcal meningitis

Abstract

Pseudo-subarachnoid hemorrhage (PSAH) is an infrequent entity characterized by findings in non- contrast head computed tomography that mimic subarachnoid hemorrhage, but without evidence of blood products in further studies. It has been associated with multiple etiologies, with hypoxic ischemic encephalopathy following cardiac arrest and cardiopulmonary resuscitation as the leading cause in literature. Clinical context and attenuation levels measured in Hounsfield Units should be taken into consideration when establishing the differential diagnosis between these entities. The case of a patient with PSAH of multifactorial etiology is presented.

Downloads

Download data is not yet available.

Author Biographies

Elkin José Beltrán Carrascal, Hospital Universidad del Norte, Barranquilla, Colombia.

Neurólogo, Pontificia Universidad Javeriana. Neurólogo y docente, Hospital Universidad del Norte. Barranquilla, Colombia.

David Cianci Bonet, Hospital Universidad del Norte, Barranquilla, Colombia.

Residente de Radiología e imágenes diagnósticas, tercer año, Universidad del Norte, Hospital Universidad del Norte. Barranquilla, Colombia.

Laura López Brokate, Hospital Universidad del Norte, Barranquilla, Colombia.

Médica general, Universidad del Norte, Hospital Universidad del Norte. Barranquilla, Colombia

Mauro Duván Mendoza Quevedo, Hospital Universidad del Norte, Barranquilla, Colombia.

Residente de Medicina interna, segundo año, Universidad del Norte, Hospital Universidad del Norte. Barranquilla, Colombia.

David Francisco Saavedra Segura, Hospital Universidad del Norte, Barranquilla, Colombia.

Residente de Medicina interna, primer año, Universidad del Norte, Hospital Universidad del Norte. Barranquilla, Colombia.

Arturo José Viera Oliveros, Hospital Universidad del Norte, Barranquilla, Colombia.

Residente de Medicina interna, segundo año. Universidad del Norte, Hospital Universidad del Norte. Barranquilla, Colombia.

References

Ferrante E, Regna-Gladin C, Arpino I, et al. Pseudo-subarachnoid hemorrhage: a potential imaging pitfall associated with spontaneous intracranial hypotension. Clin Neurol Neurosurg. 2013;115(11):2324-8. https://doi.org/10.1016/j.clineuro.2013.08.028

Spiegel S, Fox A, Vinuela F, et al. Increased density of tentorium and falx: a false positive CT sign of subarachnoid hemorrhage. Can Assoc Radiol J. 1986;37(4):243-7.

Avrahami E, Katz R, Rabin A, et al. CT diagnosis of non-traumatic subarachnoid haemorrhage in patients with brain edema. Eur J Radiol. 1998;28(3):222-5. https://doi.org/10.1016/S0720-048X(97)00162-9

Given C, Burdette J, Elster A, et al. Pseudo-subarachnoid hemorrhage: A potential imaging pitfall associated with diffuse cerebral edema. Am J Neuroradiol. 2003;24(2):254-6.

Hasan T, Duarte W, Akinduro O, et al. Nonaneurysmal "pseudo-subarachnoid hemorrhage" computed tomography patterns: challenges in an acute decision-making heuristics. J Stroke Cerebrovasc Dis. 2018;27(9):2319-26. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.04.016

Yuzawa H, Higano S, Mugikura S, et al. Pseudo-subarachnoid hemorrhage found in patients with postresuscitation encephalopathy: characteristics of CT findings and clinical importance. Am J Neuroradiol. 2008;29(8):1544-9. https://doi.org/10.3174/ajnr.A1167

Senthilkumaran S, Balamurugan N, Menezes R, et al. Role of Hounsfield units to distinguish pseudo-subarachnoid hemorrhage. Clin Toxicol. 2011;49:948. https://doi.org/10.3109/15563650.2011.629619

O'Halloran J, Franklin A, Lainhart W, et al. Pitfalls associated with the use of molecular diagnostic panels in the diagnosis of cryptococcal meningitis. Open Forum Infect Dis. 2017;4(4):ofx242. https://doi.org/10.1093/ofid/ofx242

Published

2020-12-12

How to Cite

(1)
Beltrán Carrascal, E. J.; Cianci Bonet, D.; López Brokate, L.; Mendoza Quevedo, M. D.; Saavedra Segura, D. F.; Viera Oliveros, A. J. Pseudo-Subarachnoid Hemorrhage. A Case Report. Rev. colomb. radiol. 2020, 31, 5459-5461.

Issue

Section

Case reports
Crossref Cited-by logo
QR Code