Title:CT-negative Subarachnoid Hemorrhage Caused by Telangiectasia: A Case Report
Volume: 17
Author(s): Xin Zhang, Jing Mang , Xiaohua Shi , Lei Xu*Zhongxin Xu*
Affiliation:
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun City, Jilin Province,China
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun City, Jilin Province,China
Keywords:
Subarachnoid hemorrhage, telangiectasia, capillary dilatation, lumbar puncture, CT, SWI.
Abstract:
Introduction: At present, the mechanism of telangiectasia is unknown, but some evidence
suggests that it may be related to genetic abnormalities. Telangiectasia may lead to bleeding
of multiple sites. CT-negative subarachnoid hemorrhage is rare, which is mostly related to hemorrhage
with a little amount of bleeding. CT-negative subarachnoid hemorrhage due to telangiectasia
has not been reported.
Case Report: In this case report, the patient experienced severe headache with nausea, vomiting,
and blurred vision for 12 days, and had a history of hypertension. Physical examination revealed a
clear state of mind, normal speech, normal limb muscle strength, 2 transverse fingers of neck stiffness,
and negative bilateral Babinski signs. Brain CT, MRI, MRA, and MRV showed no obvious
abnormalities. SWI suggested the possibility of capillary dilation. The cerebrospinal fluid was pale
yellow in appearance after lumbar puncture.
Diagnosis: The patient was diagnosed with subarachnoid hemorrhage (SAH) and capillary dilatation.
Interventions: Therapeutic management of blood pressure and brain edema was started.
Conclusion: Lumbar puncture should be performed when subarachnoid hemorrhage is clinically
suspected and CT is negative. While searching for the cause of subarachnoid hemorrhage, the presence
of telangiectasia should be ascertained.
