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.
No takes yet. Share an insight, caveat, or question.
Hentschel et al. (2003) studied this question.
Synapse has enriched one closely related paper. Consider it for comparative context: