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Pseudosubarachnoid haemorrhage in subdural haematoma
  1. A A Rabinstein1,
  2. S J Pittock1,
  3. G M Miller2,
  4. J J Schindler3,
  5. E F M Wijdicks1
  1. 1Department of Neurology, Saint Marys Hospital, Mayo Medical Center
  2. 2Department of Radiology, Saint Marys Hospital, Mayo Medical Center
  3. 3Department of Neurosurgery, Saint Marys Hospital, Mayo Medical Center
  1. Correspondence to:
 Dr E FM Wijdicks, Mayo Clinic, Department of Neurology, W8B, 200 First Street SW, Rochester, MN 55905, USA;


Two patients with large bilateral subdural haematomas with patterns of non-enhanced brain computed tomography (CT) falsely suggesting coexistent subarachnoid haemorrhage are presented. The CT images showed marked effacement of the basal cisterns with hyperdense signal along the tentorium, sylvian fissure, and the perimesencephalic cisterns. In both cases, the suspicion of subarachnoid haemorrhage led to the performance of angiographic studies to rule out vascular lesions. Thus, recognition of this radiological feature is important to avoid unnecessary testing and treatment delay.

  • CT scan
  • false subarachnoid haemorrhage
  • pseudosubarachnoid haemorrhage
  • subdural haematoma
  • CT, computed tomography
  • MRI, magnetic resonance imaging
  • SAH, subarachnoid haemorrhage
  • SDH, subdural haematoma
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  • Competing interests: none declared

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