A classic case of pseudo subarachnoid haemorrhage (SAH) due to secondary polycythemia

Presentation of symptoms and clinical history significantly differentiates true acute subarachnoid haemorrhage (SAH)from pseudo-SAH. We report a 25-year-old man who presented with recurrent headaches and has been attending a pulmonologist for recurrent chest infections. Non-Enhanced CT(NECT) of the...

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Bibliographic Details
Published inInternational Journal of Medical Reviews and Case Reports Vol. 6; no. Reports in Clinical Medicine a; p. 1
Main Authors Katamreddy, Alekya, Manchikanti, Venkatesh
Format Journal Article
LanguageEnglish
Published 2022
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Summary:Presentation of symptoms and clinical history significantly differentiates true acute subarachnoid haemorrhage (SAH)from pseudo-SAH. We report a 25-year-old man who presented with recurrent headaches and has been attending a pulmonologist for recurrent chest infections. Non-Enhanced CT(NECT) of the brain was done, which showed extra-axial sulcal hyper density along cerebral arteries and hyperdense venous sinuses. MR imaging confirmed the linear hypointensity along vessels on susceptibility-weighted images(SWI), suggesting an increased concentration of paramagnetic deoxyhemoglobin within cerebral vessels; findings suggested polycythaemia mimicking SAH. Pseudo SAH is a potential mimic of SAH. Awareness of various manifestations of pseudo-SAH is essential for proper treatment, avoiding unnecessary investigative modalities like angiographic studies, invasive procedures like Lumbar puncture, etc. Polycythaemia presenting as pseudo subarachnoid haemorrhage is a rare differential. Clinical history and MR imaging help to differentiate SAH from pseudo-SAH.
ISSN:2534-9821
2534-9821
DOI:10.5455/IJMRCR.172-1623906901