Pseudo-subarachnoid hemorrhage in cerebellar infarction

Abstract

Introduction: The computed tomography (CT) appearance of subarachnoid hemorrhage (SAH) without subarachnoid blood has been labeled "pseudo-subarachnoid hemorrhage" (pseudo-SAH) and has been reported with several diffuse intracerebral insults including intrathecal contrast agents, meningitis, generalized cerebral edema, anoxic encephalopathy, and intracranial hypotension.

Methods: Single case report.

Results: We present a 43-year-old female who presented with vertigo and severe headache. Initial CT brain suggested SAH with hydrocephalus. Subsequent cerebral angiography was negative. Cerebrospinal fluid from an external ventricular drain (EVD) was negative for blood, and MRI brain revealed an acute stroke in the posterior inferior cerebellar artery (PICA) territory.

Conclusion: Our case suggests that PICA infarction can be associated with the CT finding of pseudo-SAH, thereby mimicking the clinical and radiographic presentation of SAH.