What are the 10 CT pitfalls of subarachnoid haemorrhage?

Pseudo-subarachnoid hemorrhage: a potential imaging pitfall

Lin CY, Lai PH, Fu JH, Wang PC, Pan HB.

Can Assoc Radiol J 2014; 65:225-231.

Abstract

Background:

Increased density of the basal cisterns and subarachnoid spaces on computed tomographies (CT) is a characteristic finding of acute subarachnoid hemorrhage (SAH). Excluding head injury, SAH leads to the performance of angiographic studies to rule out vascular lesions. Thus, recognition of the radiologic feature of pseudo-SAH on CT is important to avoid unnecessary testing and treatment delay.

Results:

Several mimics of SAH have been reported:

  1. Diffuse cerebral oedema due to various causes
  2. Purulent meningitis
  3. Cerebral infarction
  4. Subdural hematoma (SDH)
  5. Leakage of intravenous contrast into the subarachnoid space
  6. Status epilepticus
  7. Intracranial hypotension
  8. Intrathecally administered contrast medium and
  9. Polycythemia

This pictorial essay presents the varied manifestation of radiologic mimics of SAH.

This paper is cited in the neurochecklist:

Subarachnoid haemorrhage (SAH): investigations

Article link

By James Heilman, MDOwn work, CC BY-SA 3.0, Link
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