Majed Abdulrahman Alghamdi1, Abdulaziz Oqalaa Almubarak2, Nora Alsedrani3, Waleed M Alshehri1, Abdulrahman Y Alturki4. 1. National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia. 2. National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia; Prince Mohammed Medical City, Aljouf, Saudi Arabia. 3. National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia; College of Medicine, Qassim University, Buraydah, Saudi Arabia. 4. National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia. Electronic address: dr.alturki.neurosurgery@gmail.com.
Abstract
BACKGROUND: Pretruncal nonaneurysmal subarachnoid hemorrhage (PNSAH) accounts for 15%-12% of all case of subarachnoid hemorrhage. Its precise etiology is not yet established. Multiple theories and risk factors have been investigated to address the possible cause of this type of hemorrhage including basilar tip dissecting aneurysms, high spinal arteriovenous fistula, venous stenosis/hypertension or venous bleeding. Hereditary coagulopathies and hemophilias have rarely been reported in the literature as a potential cause of PNSAH. CASE DESCRIPTION: Here, we reported a rare case of PNSAH with negative angiogram and magnetic resonance imaging who was also found to have hemophilia C (factor XI deficiency) confirmed by laboratory investigation. We also included a literature review of hereditary coagulopathies and their role as a possible cause of PNSAH. CONCLUSIONS: Detailed medical history and physical examination of patients with PNSAH may lead to further hematologic evaluation for this group of patients, as in this case, and may reveal more cases of mild coagulopathy that require treatment.
BACKGROUND:Pretruncal nonaneurysmal subarachnoid hemorrhage (PNSAH) accounts for 15%-12% of all case of subarachnoid hemorrhage. Its precise etiology is not yet established. Multiple theories and risk factors have been investigated to address the possible cause of this type of hemorrhage including basilar tip dissecting aneurysms, high spinal arteriovenous fistula, venous stenosis/hypertension or venous bleeding. Hereditary coagulopathies and hemophilias have rarely been reported in the literature as a potential cause of PNSAH. CASE DESCRIPTION: Here, we reported a rare case of PNSAH with negative angiogram and magnetic resonance imaging who was also found to have hemophilia C (factor XI deficiency) confirmed by laboratory investigation. We also included a literature review of hereditary coagulopathies and their role as a possible cause of PNSAH. CONCLUSIONS: Detailed medical history and physical examination of patients with PNSAH may lead to further hematologic evaluation for this group of patients, as in this case, and may reveal more cases of mild coagulopathy that require treatment.