Pseudo-subarachnoid hemorrhage in a patient with hypoxic encephalopathy

Neurochirurgie. 2015 Feb;61(1):35-7. doi: 10.1016/j.neuchi.2014.08.003. Epub 2015 Jan 9.

Abstract

The authors report an unusual case of diffuse subarachnoid hemorrhage on brain computed tomography (CT) scan in a patient with post-resuscitation anoxic encephalopathy. A 42-year-old woman suffered both respiratory and cardiac arrest, associated with hypoxic encephalopathy, which occurred during a visit to our gynecology clinic. CT examination was performed the next day, which revealed a hyperdensity in the basal cisterns with a diffuse cerebral edema. Lumbar puncture was applied for diagnosis. No yellow coloration or red cells were observed in the cerebrospinal fluid. Nineteen days after treatment, the CT examination revealed features of a subarachnoid hemorrhage with a significantly increased cerebral edema. The patient died two months later. This clinical case illustrates that hypoxic encephalopathy can mimic diffuse subarachnoid hemorrhage on CT scan.

Keywords: Cerebral edema; Encephaledema; High-density sign; Hyperdensity; Hyperdensité; Hyperdensité au scanner; Pseudo-hémorragie sous-arachnoïdienne; Pseudo-subarachnoid hemorrhage; Pseudo-subarachnoid hemorrhage signs; Signe de pseudo-hémorragie sous-arachnoïdienne; Œdème cérébral; Œdème encéphalique.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain Edema / diagnostic imaging
  • Brain Edema / etiology
  • Diagnosis, Differential
  • Fatal Outcome
  • Female
  • Heart Arrest / etiology
  • Heart Arrest / therapy
  • Humans
  • Hypoxia, Brain / cerebrospinal fluid
  • Hypoxia, Brain / complications*
  • Hypoxia, Brain / diagnostic imaging
  • Spinal Puncture
  • Subarachnoid Hemorrhage / cerebrospinal fluid
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Subarachnoid Hemorrhage / etiology*
  • Tomography, X-Ray Computed