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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(02): 510-512
DOI: 10.4103/ajns.AJNS_11_19
Original Article

Bilateral chronic subdural hematoma presenting with pseudo-subarachnoid hemorrhage sign on computed tomography

Hiroshi Shima
Department of Neurosurgery, Shima Neurosurgical and Orthopedic Clinic, Kanto Rosai Hospital, Kawasaki
,
Kazutaka Shirokane
1   Department of Neurosurgery, Kanto Rosai Hospital, Kawasaki
,
Eiichi Baba
1   Department of Neurosurgery, Kanto Rosai Hospital, Kawasaki
,
Atsushi Tsuchiya
2   Department of Neurology, Kanto Rosai Hospital, Kawasaki
,
Motohiro Nomura
1   Department of Neurosurgery, Kanto Rosai Hospital, Kawasaki
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Background: On rare occasions, cisterns are demonstrated as high-density areas on computed tomography (CT) and misdiagnosed with subarachnoid hemorrhage (SAH). This false-positive finding is called pseudo-SAH. Patients and Methods: From April 2014 to August 2018, a total of 161 patients with chronic subdural hematoma (CSDH) were treated in our hospital. For these cases, the existence of a pseudo-SAH sign on CT was retrospectively examined. Results: One patient with bilateral CSDH showed pseudo-SAH and a further examination to evaluate vascular abnormalities causing true SAH was necessary. In three patients, the Sylvian fissures were demonstrated as high-density areas due to an atherosclerotic middle cerebral artery; however, the condition was not misdiagnosed with SAH. Conclusion: In cases of CSDH, there is a possibility that CT demonstrates a pseudo-SAH sign. In such cases, close examinations to exclude true SAH are mandatory.

Key-words:

Bilateral - chronic subdural hematoma - computed tomography - pseudo-subarachnoid hemorrhage

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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