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Revision as of 18:53, 20 June 2020

A pseudosubarachnoid hemorrhage is an apparent increased attenuation on CT scans within the basal cisterns that mimics a true subarachnoid hemorrhage.[1] This occurs in cases of severe cerebral edema, such as by cerebral hypoxia. It may also occur due to intrathecally administered contrast material,[2] leakage of high-dose intravenous contrast material into the subarachnoid spaces, or in patients with cerebral venous sinus thrombosis, severe meningitis, leptomeningeal carcinomatosis,[3] intracranial hypotension, cerebellar infarctions, or bilateral subdural hematomas.[4]

In a true subarachnoid hemorrhage, there is higher attenuation of the basal cisterns, and blood that has leaked from a vessel or formed a hematoma is more highly attenuated due to the absorption of plasma.[5] Pseudosubarachnoid hemorrhages have been observed in as much as 20% of patients resuscitated from non-traumatic cardiopulmonary arrest. Patients with pseudosubarachnoid hemorrhages may have worse prognoses than those with true subarachnoid hemorrhages because of underlying disease processes and decreased cerebral perfusion with elevated intracranial pressure.[6] The identification of a pseudosubarachnoid hemorrhage as opposed to a true subarachnoid hemorrhage may therefore change a patient's treatment plan.

References

Citations

  1. ^ Dixon, Andrew. "Pseudosubarachnoid hemorrhage | Radiology Reference Article | Radiopaedia.org". Radiopaedia.
  2. ^ Given, Curtis A.; Burdette, Jonathan H.; Elster, Allen D.; Williams, Daniel W. (1 February 2003). "Pseudo-Subarachnoid Hemorrhage: A Potential Imaging Pitfall Associated with Diffuse Cerebral Edema". American Journal of Neuroradiology. pp. 254–256.
  3. ^ Marder, Carrie P.; Narla, Vinod; Fink, James R.; Tozer Fink, Kathleen R. (26 December 2013). "Subarachnoid Hemorrhage: Beyond Aneurysms". American Journal of Roentgenology. pp. 25–37. doi:10.2214/AJR.12.9749.
  4. ^ Coulier, Bruno (1 March 2018). "Pseudo-subarachnoid Hemorrhage". Journal of the Belgian Society of Radiology. p. 32. doi:10.5334/jbsr.1509.{{cite web}}: CS1 maint: unflagged free DOI (link)
  5. ^ Ramanathan, Ramnath Santosh (2018). "Pseudo-subarachnoid Hemorrhage Sign". Annals of Indian Academy of Neurology. pp. 83–84. doi:10.4103/aian.AIAN_152_17.{{cite web}}: CS1 maint: unflagged free DOI (link)
  6. ^ "Pseudo-Subarachnoid Hemorrhage after Cardiac Arrest". The Western Journal of Emergency Medicine. 31 May 2020.

Additional Sources