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OtherBRAIN

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

Curtis A. Given, Jonathan H. Burdette, Allen D. Elster and Daniel W. Williams
American Journal of Neuroradiology February 2003, 24 (2) 254-256;
Curtis A. Given II
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Jonathan H. Burdette
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Allen D. Elster
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Daniel W. Williams III
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    Fig 1.

    Case 1. Axial nonenhanced CT images through the basal cisterns.

    A, Image obtained before contrast enhancement reveals abnormally increased attenuation within the basal cisterns (arrows).

    B, The basal cisterns (arrowheads) are enhancing after the intravenous administration of contrast material.

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    Fig 2.

    Case 6. Axial nonenhanced CT images through the basal cisterns.

    A, Image reveals effacement of and increased attenuation within the basal cisterns (arrowheads).

    B, The findings were not present on the prior image obtained approximately 3 days earlier.

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  • Summary of clinical and imaging findings

    CasePatient Age/SexSigns of Edema*Attenuation Value (HU)†Proof‡Diagnosis at Death or Discharge§
    15 y/MC, ENAAutopsy resultDiffuse cerebral edema secondary to hyponatremia
    237 y/FC, E, GWNAAutopsy resultSudden cardiac death, anoxic injury
    322 y/MC, ENANegative LP resultPseudo-tumor cerebri
    422 y/FC, ENAAutopsy resultDKA with hypoxic and metabolic encephalopathy
    58 mo/FE, GW29Negative LP resultDiffuse cerebral edema, SIDS
    65 y/MC, E, GW33Negative LP resultCardiopulmonary failure secondary to unknown metabolic disorder (possibly Leigh disease)
    76 y/MC, E, GW29Negative LP resultSeptic Shock
    • * C indicates compression and/or mass effect on the fourth ventricle; E, effacement of the basal cisterns and cortical sulci; GW, decreased gray matter–white matter differentiation.

    • † Mean attenuation levels were obtained with a region of interest drawn in the basal cisterns. NA indicates not available.

    • ‡ LP indicates lumbar puncture.

    • § DKA indicates diabetic ketoacidosis; SIDS, sudden infant death syndrome.

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American Journal of Neuroradiology: 24 (2)
American Journal of Neuroradiology
Vol. 24, Issue 2
1 Feb 2003
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Pseudo-Subarachnoid Hemorrhage: A Potential Imaging Pitfall Associated with Diffuse Cerebral Edema
Curtis A. Given, Jonathan H. Burdette, Allen D. Elster, Daniel W. Williams
American Journal of Neuroradiology Feb 2003, 24 (2) 254-256;

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Pseudo-Subarachnoid Hemorrhage: A Potential Imaging Pitfall Associated with Diffuse Cerebral Edema
Curtis A. Given, Jonathan H. Burdette, Allen D. Elster, Daniel W. Williams
American Journal of Neuroradiology Feb 2003, 24 (2) 254-256;
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