Spontaneous convexial subarachnoid haemorrhage: a case series with different etiologic diagnoses

Özet

Objective: Non-traumatic acute convexity subarachnoid haemorrhage (cSAH) is a rare condition caused by various vascular-nonvascular pathologies. The aim of this study was to evaluate the etiologic background of patients with cSAH. Methods: For this purpose, the files of the patients with cSAH were retrospectively reviewed. The demographic data, clinical presentation, complementary investigations, etiology, and outcome of five patients with cSAH due to amyloid angiopathy and cerebral venous thrombosis were recorded. Results: There were five patients with cSAH; 4 were women.The most common clinical presentation was focal neurologic signs, followed by acute headache and seizures. Detailed investigations revealed different causes of cSAH as follows: amyloid angiopathy (n=4) and cerebral vein thrombosis (CVT) (n=1). The patient with etiologic diagnoses of CVT was younger than 40 years, and the other patients with amyloid angiopathy were older than 65 years. The haemorrhagic lesion was bilateral in two cases with CVT and amyloid angiopathy. The outcome was favourable in four patients; one patient (case 4), who presented with a higher National Institutes of Health Stroke Scale died. Conclusion: The etiologic diagnosis of cSAH is essential for determining treatment. Complete diagnostic examination, including parenchymal and vascular imaging should be performed.