title: Acute subarachnoid hemorrhage. An unusual clinical presentation of cerebral venous sinus thrombosis.
abstract: Ruptured cerebral aneurysm is the most common cause of spontaneous subarachnoid hemorrhage (SAH). Rarely cerebral venous sinus thrombosis (CVST) may present initially as acute SAH, and clinically mimics aneurysmal bleed. We report 2 cases of CVST who presented with severe headache associated with neck pain and focal seizures. Non-contrast brain CT showed SAH, involving the sulci of the convexity of hemisphere (cSAH) without involving the basal cisterns. Both patients received treatment with anticoagulants and improved. Awareness of this unusual presentation of CVST is important for early diagnosis and treatment. The purpose of this paper is to emphasize the inclusion of vascular neuroimaging like MRI with venography or CT venography in the diagnostic workup of SAH, especially in a patient with strong clinical suspicion of CVST or in a patient where neuroimaging showed cSAH.
authors: Department of Medicine, Section of Neurology, College of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia. E-mail: ali.hassan.neurology@gmail.com.
authors: Ali
authors: A
authors: Hassan
authors: Bakhtiar
authors: B
authors: Ahmad
authors: Zahoor
authors: Z
authors: Ahmed
authors: Khalid W
authors: KW
authors: Al-Quliti
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D002533:Cerebral Angiography / Q000379:methods; D003392:Cranial Sinuses / Q000473:pathology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012851:Sinus Thrombosis, Intracranial / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants
references: Rev Neurol (Paris). 2014 Feb;170(2):110-8
references: 24411684
references: Lancet Neurol. 2007 Feb;6(2):162-70
references: 17239803
references: Clin Imaging. 2014 Jul-Aug;38(4):373-9
references: 24746346
references: AJNR Am J Neuroradiol. 2005 Mar;26(3):614-7
references: 15760875
references: Eur J Neurol. 2010 Oct;17(10):1249-58
references: 20402745
references: Stroke. 2014 Apr;45(4):1151-3
references: 24496391
references: Iran J Med Sci. 2011 Sep;36(3):178-82
references: 23359749
references: J Thromb Haemost. 2010 May;8(5):877-83
references: 20149074
references: Stroke. 2011 Jan;42(1):227-76
references: 20966421
references: AJR Am J Roentgenol. 2006 Dec;187(6):1637-43
references: 17114562