Development of pseudo-subarachnoid hemorrhage secondary to hypoxic-ischemic injury due to bleeding pulmonary artery-venous malformation

Background: The computed tomography (CT) finding of a pseudo-subarachnoid hemorrhage (SAH) may lead the treating physician into a diagnostic dilemma. We present a case of a pseudo-SAH in a patient with post-resuscitative encephalopathy, secondary to a newly diagnosed bleeding pulmonary arterio-venou...

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Main Authors: Md Noh, Mohamad Syafeeq Faeez, Abdul Rashid, Anna Misya'il
Format: Article
Language:English
Published: BioMed Central 2018
Online Access:http://psasir.upm.edu.my/id/eprint/72270/
http://psasir.upm.edu.my/id/eprint/72270/1/Development%20of%20pseudo-subarachnoid.pdf
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author Md Noh, Mohamad Syafeeq Faeez
Abdul Rashid, Anna Misya'il
author_facet Md Noh, Mohamad Syafeeq Faeez
Abdul Rashid, Anna Misya'il
author_sort Md Noh, Mohamad Syafeeq Faeez
building UPM Institutional Repository
collection Online Access
description Background: The computed tomography (CT) finding of a pseudo-subarachnoid hemorrhage (SAH) may lead the treating physician into a diagnostic dilemma. We present a case of a pseudo-SAH in a patient with post-resuscitative encephalopathy, secondary to a newly diagnosed bleeding pulmonary arterio-venous malformation (AVM). Case presentation: A 19-year-old female presented acutely with massive hemoptysis. Cardiopulmonary resuscitation (CPR) followed, and the patient was subsequently intubated for airway protection with intensive care unit (ICU) admission. Urgent CT angiography of the thorax showed a bleeding pulmonary AVM, with evidence of hemothorax. Non-contrasted cranial CT initially revealed cerebral edema. Day 3 post admission, repeat cranial CT showed worsening cerebral edema, with evidence of pseudo-SAH. Patient passed away the next day. Conclusions: Pseudo-SAH, if present, carries a poor prognosis. It should be recognized as a potential CT finding in patients with severe cerebral edema, due to various causes. The diagnosis is vital, to avoid wrongful treatment institution, as well as determination of cause of death.
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spelling upm-722702020-04-28T04:25:47Z http://psasir.upm.edu.my/id/eprint/72270/ Development of pseudo-subarachnoid hemorrhage secondary to hypoxic-ischemic injury due to bleeding pulmonary artery-venous malformation Md Noh, Mohamad Syafeeq Faeez Abdul Rashid, Anna Misya'il Background: The computed tomography (CT) finding of a pseudo-subarachnoid hemorrhage (SAH) may lead the treating physician into a diagnostic dilemma. We present a case of a pseudo-SAH in a patient with post-resuscitative encephalopathy, secondary to a newly diagnosed bleeding pulmonary arterio-venous malformation (AVM). Case presentation: A 19-year-old female presented acutely with massive hemoptysis. Cardiopulmonary resuscitation (CPR) followed, and the patient was subsequently intubated for airway protection with intensive care unit (ICU) admission. Urgent CT angiography of the thorax showed a bleeding pulmonary AVM, with evidence of hemothorax. Non-contrasted cranial CT initially revealed cerebral edema. Day 3 post admission, repeat cranial CT showed worsening cerebral edema, with evidence of pseudo-SAH. Patient passed away the next day. Conclusions: Pseudo-SAH, if present, carries a poor prognosis. It should be recognized as a potential CT finding in patients with severe cerebral edema, due to various causes. The diagnosis is vital, to avoid wrongful treatment institution, as well as determination of cause of death. BioMed Central 2018 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/72270/1/Development%20of%20pseudo-subarachnoid.pdf Md Noh, Mohamad Syafeeq Faeez and Abdul Rashid, Anna Misya'il (2018) Development of pseudo-subarachnoid hemorrhage secondary to hypoxic-ischemic injury due to bleeding pulmonary artery-venous malformation. BMC Neurology, 18. art. no. 157. pp. 1-3. ISSN 1471-2377 https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-018-1161-x 10.1186/s12883-018-1161-x
spellingShingle Md Noh, Mohamad Syafeeq Faeez
Abdul Rashid, Anna Misya'il
Development of pseudo-subarachnoid hemorrhage secondary to hypoxic-ischemic injury due to bleeding pulmonary artery-venous malformation
title Development of pseudo-subarachnoid hemorrhage secondary to hypoxic-ischemic injury due to bleeding pulmonary artery-venous malformation
title_full Development of pseudo-subarachnoid hemorrhage secondary to hypoxic-ischemic injury due to bleeding pulmonary artery-venous malformation
title_fullStr Development of pseudo-subarachnoid hemorrhage secondary to hypoxic-ischemic injury due to bleeding pulmonary artery-venous malformation
title_full_unstemmed Development of pseudo-subarachnoid hemorrhage secondary to hypoxic-ischemic injury due to bleeding pulmonary artery-venous malformation
title_short Development of pseudo-subarachnoid hemorrhage secondary to hypoxic-ischemic injury due to bleeding pulmonary artery-venous malformation
title_sort development of pseudo-subarachnoid hemorrhage secondary to hypoxic-ischemic injury due to bleeding pulmonary artery-venous malformation
url http://psasir.upm.edu.my/id/eprint/72270/
http://psasir.upm.edu.my/id/eprint/72270/
http://psasir.upm.edu.my/id/eprint/72270/
http://psasir.upm.edu.my/id/eprint/72270/1/Development%20of%20pseudo-subarachnoid.pdf