Pseudosubarachnoid hemorrhage
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 on CT scans 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.[citation needed]
References
[edit]- ^ Dixon, Andrew. "Pseudosubarachnoid hemorrhage | Radiology Reference Article | Radiopaedia.org". Radiopaedia.
- ^ 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". AJNR. American Journal of Neuroradiology. 24 (2): 254–256. PMC 7974121. PMID 12591643.
- ^ Marder, Carrie P.; Narla, Vinod; Fink, James R.; Tozer Fink, Kathleen R. (26 December 2013). "Subarachnoid Hemorrhage: Beyond Aneurysms". American Journal of Roentgenology. 202 (1): 25–37. doi:10.2214/AJR.12.9749. PMID 24370126.
- ^ Coulier, Bruno (1 March 2018). "Pseudo-subarachnoid Hemorrhage". Journal of the Belgian Society of Radiology. 102 (1): 32. doi:10.5334/jbsr.1509. PMC 6032606. PMID 30039044.
- ^ Ramanathan, Ramnath Santosh (2018). "Pseudo-subarachnoid Hemorrhage Sign". Annals of Indian Academy of Neurology. 21 (1): 83–84. doi:10.4103/aian.AIAN_152_17. PMC 5909155. PMID 29720807.
- ^ "Pseudo-Subarachnoid Hemorrhage after Cardiac Arrest". The Western Journal of Emergency Medicine. 31 May 2020.
Sources
[edit]- Xavier, João; Vasconcelos, Cristiana; Ramos, Cristina (2018). Diagnostic and Therapeutic Neuroradiology: A Case-Based Guide to Good Practice. Springer. p. 207. ISBN 978-3-319-61140-2.
- Caplan, Louis R. (2016). Caplan's Stroke: A Clinical Approach. Cambridge University Press. pp. 368–69. ISBN 978-1-316-55279-7.
- Kleinman, Paul K. (2015). Diagnostic Imaging of Child Abuse. Cambridge University Press. p. 406. ISBN 978-1-316-29818-3.
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