Localized pseudo-subarachnoid hemorrhage

Abstract

Abstract Background: To analyze the imaging and clinical data of patients with localized pseudo-subarachnoid hemorrhage (pseudo-SAH), so as to improve the correct understanding of this sign by radiologists. Methods: The imaging and clinical data of patients with localized pseudo-SAH on head CT scan without contrast from January 2013 to March 2022 were retrospectively analyzed, and the imaging and clinical characteristics were summarized. Results: The etiology of 9 patients with pseudo-SAH was viral encephalitis (2 cases), acute cerebral infarction (4 cases) and hypoxic ischemic encephalopathy (3 cases). All patients underwent CT scan without contrast, CT scan with contrast, MRI and lumbar puncture examination. All patients' head CT scan without contrast showed local swelling of brain tissue (less than two lobes), stenosis and occlusion of adjacent subarachnoid space, with its inner strip of high-density shadow. CT scan with contrast found that the high density shadow was significantly enhanced. MRI and lumbar puncture were performed to rule out true SAH and confirm pseudo-SAH. Finally, 8 patients were discharged from hospital after treatment, and 1 patient died of multiple organ failure. Conclusion: Localized pseudo-SAH often indicates localized brain lesions and has a relatively good prognosis. It has certain characteristics in CT value, enhancement mode and morphology.