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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 24:254-256, February 2003
© 2003 American Society of Neuroradiology

Case Report
BRAIN

Pseudo-Subarachnoid Hemorrhage: A Potential Imaging Pitfall Associated with Diffuse Cerebral Edema

Curtis A. Given, II^a, Jonathan H. Burdette^a, Allen D. Elster^a and Daniel W. Williams, III^a

^a From the Departments of Neuroradiology (C.A.G., J.H.B., D.W.W.) and Radiology (A.D.E.), Wake Forest University Baptist Medical Center, Winston-Salem, NC

Address reprint requests to Curtis A. Given II, MD, University of Kentucky, Department of Radiology, Room HX-311C, 800 Rose Street, Lexington, KY 40536

Summary: We report CT findings in seven patients with diffuse cerebral edema and increased attenuation in the basilar cisterns resembling subarachnoid hemorrhage. On the basis of autopsy (three cases) and lumbar puncture (four cases) findings, true subarachnoid hemorrhage was reasonably excluded. Pathophysiologic changes that occur with diffuse cerebral edema are explored, with proposed explanations for the appearance of a pseudo-subarachnoid hemorrhage.

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