Occurrence of perimesencephalic subarachnoid hemorrhage during pregnancy.
BACKGROUND
Perimesencephalic subarachnoid hemorrhage (P-SAH) is a benign subset of subarachnoid hemorrhage with a favorable prognosis and low rate of re-bleeding. Risk factors may include hypertension and tobacco use, but it has not previously been reported during pregnancy.


METHODS
We report two cases of P-SAH in pregnant women, a 40-year-old female, 8-weeks pregnant and a 37-year-old female at 35 weeks gestational age.


RESULTS
CT scan confirmed P-SAH in both cases. CT angiography in one case and cerebral angiogram in the other did not reveal aneurysm or other potential bleeding source. The patients underwent transcranial Doppler ultrasound monitoring without evidence of vasospasm.


CONCLUSIONS
P-SAH hemorrhage may occur during early or late pregnancy. We do not propose an increased risk of P-SAH during pregnancy. The clinical course appears favorable and CT angiography alone may be considered the preferred diagnostic test to assess for aneurysm in first trimester pregnancy.
Hirsch
Karen G
KG
Department of Neurology, Johns Hopkins University School of Medicine, Meyer 8-140, 600 N. Wolfe St., Baltimore, MD, USA.
Froehler
Michael T
MT
Huang
Judy
J
Ziai
Wendy C
WC
D000328:Adult; D005260:Female; D006801:Humans; D008636:Mesencephalon; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy