Pseudosubarachnoid hemorrhage
Pseudo-SAB bei hypoxischem Hirnschaden
Pseudo-SAB
bei hypoxischem Hirnschaden
Pseudosubarachnoid hemorrhage • Hypoxic-ischemic brain injury - Ganzer Fall bei Radiopaedia
Pseudosubarachnoid
hemorrhage • Hypoxic-ischemic brain injury - Ganzer Fall bei Radiopaedia
Severe hypoxic - ischaemic brain injury: the reversal, the pseudo-subarachnoid haemorrhage and the white cerebellum signs on CT. Pseudo-subarachnoid haemorrhage sign: unenhanced brain CT revealed diffuse brain oedema, effacement of the CSF-containing spaces and hyperdense appearance of tentorium cerebelli (arrows).
Severe
hypoxic - ischaemic brain injury: the reversal, the pseudo-subarachnoid haemorrhage and the white cerebellum signs on CT. Pseudo-subarachnoid haemorrhage sign: unenhanced brain CT revealed diffuse brain oedema, effacement of the CSF-containing spaces and hyperdense appearance of tentorium cerebelli (arrows).
Severe hypoxic - ischaemic brain injury: the reversal, the pseudo-subarachnoid haemorrhage and the white cerebellum signs on CT. Pseudo-subarachnoid haemorrhage sign: unenhanced brain CT revealed diffuse brain oedema, effacement of the CSF-containing spaces and hyperdense appearance of tentorium cerebelli (arrows).
Severe
hypoxic - ischaemic brain injury: the reversal, the pseudo-subarachnoid haemorrhage and the white cerebellum signs on CT. Pseudo-subarachnoid haemorrhage sign: unenhanced brain CT revealed diffuse brain oedema, effacement of the CSF-containing spaces and hyperdense appearance of tentorium cerebelli (arrows).
Severe hypoxic - ischaemic brain injury: the reversal, the pseudo-subarachnoid haemorrhage and the white cerebellum signs on CT. Pseudo-subarachnoid haemorrhage sign: unenhanced brain CT revealed diffuse brain oedema, effacement of the CSF-containing spaces and hyperdense appearance of tentorium cerebelli (arrows).
Severe
hypoxic - ischaemic brain injury: the reversal, the pseudo-subarachnoid haemorrhage and the white cerebellum signs on CT. Pseudo-subarachnoid haemorrhage sign: unenhanced brain CT revealed diffuse brain oedema, effacement of the CSF-containing spaces and hyperdense appearance of tentorium cerebelli (arrows).
Severe hypoxic - ischaemic brain injury: the reversal, the pseudo-subarachnoid haemorrhage and the white cerebellum signs on CT. Pseudo-subarachnoid haemorrhage sign: unenhanced brain CT revealed diffuse brain oedema and increased attenuation within the basal cisterns with hyperdense appearance of tentorium cerebelli (arrows).
Severe
hypoxic - ischaemic brain injury: the reversal, the pseudo-subarachnoid haemorrhage and the white cerebellum signs on CT. Pseudo-subarachnoid haemorrhage sign: unenhanced brain CT revealed diffuse brain oedema and increased attenuation within the basal cisterns with hyperdense appearance of tentorium cerebelli (arrows).
Severe hypoxic - ischaemic brain injury: the reversal, the pseudo-subarachnoid haemorrhage and the white cerebellum signs on CT. Pseudo-subarachnoid haemorrhage sign: unenhanced brain CT revealed diffuse brain oedema and increased attenuation within the basal cisterns with hyperdense appearance of tentorium cerebelli (arrows).
Severe
hypoxic - ischaemic brain injury: the reversal, the pseudo-subarachnoid haemorrhage and the white cerebellum signs on CT. Pseudo-subarachnoid haemorrhage sign: unenhanced brain CT revealed diffuse brain oedema and increased attenuation within the basal cisterns with hyperdense appearance of tentorium cerebelli (arrows).
White cerebellum sign • Diffuse hypoxic ischemic brain injury - Ganzer Fall bei Radiopaedia
White
cerebellum sign • Diffuse hypoxic ischemic brain injury - Ganzer Fall bei Radiopaedia
Pseudosubarachnoid hemorrhage • Hypoxic brain injury with pseudosubarachnoid hemorrhage - Ganzer Fall bei Radiopaedia
Pseudosubarachnoid
hemorrhage • Hypoxic brain injury with pseudosubarachnoid hemorrhage - Ganzer Fall bei Radiopaedia
ähnliche SuchenPseudosubarachnoid hemorrhage describes an apparent increased attenuation within the basal cisterns simulating true subarachnoid hemorrhage. It is usually due to cerebral edema.
Pathology
Etiology
The most common cause is cerebral edema where there is a decrease in parenchymal attenuation and engorgement and dilatation of the superficial venous structures due to an increased intracranial pressure . This is seen in hypoxic-ischemic brain injury and recent resuscitation from cardiopulmonary arrest.
Other causes include:
- severe meningitis: breakdown of the blood-brain barrier allowing mildly hyperdense proteinaceous material to leak into the subarachnoid space
- venous sinus thrombosis
- bilateral large subdural hemorrhage producing effacement of sulci and basal cisterns and the false impression of blood in the subarachnoid space
- intrathecal contrast
Radiographic features
CT
- usually, symmetrical density confined to the basal cisterns (i.e. no sulcal density)
- 30-40 HU (cf. true acute subarachnoid hemorrhage ~60 HU)
- often seen with generalized cerebral edema or basal cistern effacement
- the appearances are thought to be due to a combination of
- cisternal effacement
- distention +/- thrombosis of vessels
- adjacent brain hypoattenuation accentuating contrast difference
Given et al. reviewed 7 cases of generalized cerebral edema accompanied by increased basal cisternal attenuation which were all found not to have subarachnoid blood at lumbar puncture or autopsy .
Differential diagnosis
- true subarachnoid hemorrhage
- acute meningitis mimicking a subarachnoid hemorrhage
Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Pseudosubarachnoidalblutung:
