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Non-Traumatic Non-Aneurysmal Perimesencephalic Subarachnoid Hemorrhage as a Primary Presentation of Acute Myeloid Leukemia: an Uncommon Case Report

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Abstract

Non-aneurysmal perimesencephalic subarachnoid hemorrhage makes around 5% of subarachnoid hemorrhage which in turn represents approximately 5% of all strokes. Perimesencephalic subarachnoid hemorrhage etiology is usually unknown. In this case report, non-traumatic non-aneurysmal perimesencephalic subarachnoid hemorrhage as a primary presenting manifestation of acute myeloid leukemia is presented. Fifty-year-old female patient presented with severe headache never experienced before associated with photophobia and neck stiffness. Computed tomography revealed subarachnoid hemorrhage within the perimesencephalic region, and cerebral angiography was normal. Labs were suggestive of hematological malignancy that was confirmed as acute myeloid leukemia by bone marrow biopsy. Hematological malignancies ought to be kept in mind in any non-traumatic non-aneurysmal subarachnoid hemorrhage.

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Data Availability

The corresponding author takes full responsibility for the data, has full access to all of the data, and has the right to publish any and all data separate and apart from any sponsor.

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Not applicable.

Abbreviations

ICH :

Intracranial hemorrhage

SAH :

Subarachnoid hemorrhage

CT :

Computed tomography

CTA :

Cerebral computed tomography

MRV :

Magnetic resonance venography

CBC :

Complete blood count

PMNs :

Polymorphonuclear leukocytes

AML :

Acute myeloid leukemia

NAPSAH :

Non-aneurysmal perimesencephalic subarachnoid hemorrhage

DSA :

Digital subtraction angiography

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Authors and Affiliations

  1. Neurology Department, Faculty of Medicine, Ain Shams University, 38 Abbasia, Cairo, PO 11591, Egypt

    Tamer Roushdy, Ahmed Elbassiouny & Amr S. Zaki

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  1. Tamer Roushdy
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  2. Ahmed Elbassiouny
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  3. Amr S. Zaki
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Contributions

“Author have read and approved the manuscript”

TR: concept behind the work, drafting and revising the manuscript, collecting and supervising the case medical history and investigations, AE: supervising the case medical history and investigations, revising the manuscript, AZ: drafting and revising the manuscript, collecting and supervising the case medical history and investigations.

Corresponding author

Correspondence to Tamer Roushdy.

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Ethics Approval

All procedures performed in the study were in accordance with the ethical standards of the Faculty of Medicine, Ain Shams University Research and Ethical Committee, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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An informal written consent was obtained from the patient to participate in the current case report.

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Written informed consent was obtained from participant for publication of this case report and accompanying images.

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The authors declare no competing interests.

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Roushdy, T., Elbassiouny, A. & Zaki, A.S. Non-Traumatic Non-Aneurysmal Perimesencephalic Subarachnoid Hemorrhage as a Primary Presentation of Acute Myeloid Leukemia: an Uncommon Case Report. SN Compr. Clin. Med. 4, 248 (2022). https://doi.org/10.1007/s42399-022-01329-4

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