Stephen Hentschel1, Brian Toyota. 1. Department of Surgery, Division of Neurosurgery, Vancouver Hospital and Health Sciences Centre, University of British Columbia, Vancouver, BC Canada.
Abstract
OBJECTIVE: Cerebral aneurysms are the predominant cause of spontaneous subarachnoid hemorrhage (SAH). However, if an aneurysmal cause has been excluded, there remains but a short list of other potential etiologies. Cerebral neoplasms are clearly on this list but are most commonly meningiomas or metastatic lesions. This article details a case of a neoplasm that presented exclusively with SAH. CLINICAL PRESENTATION: A 40-year-old male presented with a SAH with normal cerebral angiography. The initial magnetic resonance image revealed a lesion in the right insula thought to be resolving hemorrhage. Subsequent images, however, revealed the mass to be enlarging. INTERVENTION: Craniotomy and resection of the lesion established a diagnosis of a malignant oligodendroglioma. CONCLUSION: An affirmation is made that patients experiencing 'angiographically-negative' SAH should undergo MRI, occasionally on a serial basis, to exclude other etiologies for hemorrhage, including neoplasia.
OBJECTIVE:Cerebral aneurysms are the predominant cause of spontaneous subarachnoid hemorrhage (SAH). However, if an aneurysmal cause has been excluded, there remains but a short list of other potential etiologies. Cerebral neoplasms are clearly on this list but are most commonly meningiomas or metastatic lesions. This article details a case of a neoplasm that presented exclusively with SAH. CLINICAL PRESENTATION: A 40-year-old male presented with a SAH with normal cerebral angiography. The initial magnetic resonance image revealed a lesion in the right insula thought to be resolving hemorrhage. Subsequent images, however, revealed the mass to be enlarging. INTERVENTION: Craniotomy and resection of the lesion established a diagnosis of a malignant oligodendroglioma. CONCLUSION: An affirmation is made that patients experiencing 'angiographically-negative' SAH should undergo MRI, occasionally on a serial basis, to exclude other etiologies for hemorrhage, including neoplasia.
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