Clinical Analysis Of Atraumatic Convexal Subarachnoid Hemorrhage

Objective:To investigate the clinical presentation, imaging finding, etiologies and treatment of atraumatic convexal subarachnoid hemorrhage so as to promote the public's greater awareness and knowledge of the disease.Methods:Two patients with atraumatic convexal subarachnoid hemorrhage were identified at our institution. Retrospective review of patient medical records and eight months follow-up data were performed. Meanwhile, the clinical presentation, imaging finding, etiologies and outcome of atraumatic convexal subarachnoid hemorrhage were analyzed according to the data from our patients and the review of the literature.Results:Linear hyperintensity on fluid-attenuated inversion recovery MRI were observed in both patients while their CTA, MRA, MRV and other imagings were normal. Clinical presentation varied from seizure to vertigo. One patient was asymptomatic during the follow-up and no signal abnormality was demonstrated on repeat head MRI. The other had recurrent and less severe vertigo several times after initial presentation without repeat head CT or MRI. Conclusion:Convexal subarachnoid hemorrhage is an important subtype of nonaneurysmal subarachnoid hemorrhage with diverse etiologies. Clinical presentation, neuroradiological findings, and treatment differ largely from the majority of SAHs which deserve our particular attention.