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The aim is to investigate the etiology of perimesencephalic subarachnoid hemorrhage using high-resolution imaging techniques.

February 8, 2026Open Access

Basilar artery perforator rupture as the cause of perimesencephalic subarachnoid hemorrhage.

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Retrospective analysis reveals arterial origins of perimesencephalic subarachnoid hemorrhage, suggesting new diagnostic approaches.

The aim is to investigate the etiology of perimesencephalic subarachnoid hemorrhage using high-resolution imaging techniques.
Retrospective analysis of patients with pmSAH between January 2023 and December 2024.
Exclusion of patients without cone-beam CT data or with low-quality images.
Neuroangiographers reviewed images to reach consensus on findings.
Out of 152 patients with spontaneous SAH, 22 had pmSAH according to Rinkel criteria.
Among these, 13 had high-quality CBCT data; 8 (61%) showed a basilar perforator pseudoaneurysm.
All patients achieved excellent neurological recovery without re-rupture or significant vasospasm.

Raz et al. (2026) studied this question.

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