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Perimesencephalic subarachnoid hemorrhage with a positive angiographic finding: case report and review of the literature

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Abstract

The vast majority of perimesencephalic subarachnoid hemorrhage cases are reported as negative-finding etiologies. Recently, high-resolution images allowed us to overcome the previous difficulty of finding the source of bleeding, which underlies the concept of a “negative finding”. We discovered a venous etiology, hidden behind the tip of the basilar artery; namely, the lateral pontine vein. Here, we review the literature on perimesencephalic subarachnoid hemorrhage and on venous aneurysm. We highlight this type of aneurysm as a candidate source of perimesencephalic hemorrhage. This case may change our way of dealing with what we have termed a negative finding of subarachnoid hemorrhage.

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Acknowledgments

The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices in this article.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Topeliuksenkatu 5, PB-266, 00029, Hus, Finland

    Ahmad Hafez, Raj Rahul & Mika Niemelä

  2. Department of Radiology, University of Helsinki and Helsinki University Hospital, Topeliuksenkatu 5, PB-266, 00029, Hus, Finland

    Jussi Numminen & Juha Järveläinen

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  1. Ahmad Hafez
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  2. Jussi Numminen
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  3. Raj Rahul
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Correspondence to Ahmad Hafez.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers, bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patient-licensing agreement), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Hafez, A., Numminen, J., Rahul, R. et al. Perimesencephalic subarachnoid hemorrhage with a positive angiographic finding: case report and review of the literature. Acta Neurochir 158, 1045–1049 (2016). https://doi.org/10.1007/s00701-016-2801-9

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  • DOI: https://doi.org/10.1007/s00701-016-2801-9

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