Abstract:

Objective To explore clinical features of subarachnoid hemorrhage (SAH) with negative imaging findings, aiming to decrease misdiagnosis rate and mortality. Methods A case of SAH with negative imaging findings was retrospectively analyzed and relevant literatures were reviewed. Results A 40-year-old female presented with 10 days of headache and 1 day of severe back pain. Lumbar puncture and the following examination showed uniform bloody cerebrospinal fluid, and SAH was clearly diagnosed. Brain computed tomography, spinal magnetic resonance, brain and spinal angiography findings were all negative. After three months, re-examined computed tomography angiography (CTA) of the brain and neck were negative, indicating that the patient was recovered well. Conclusion For patients with SAH and negative CTA findings of the brain, screening of cerebrospinal fluid and imaging examination are necessary to avoid the delayed diagnosis and treatment. A long-term imaging follow-up is needed to those with negative imaging findings, thus reducing the harm of SAH caused by intracranial aneurysm rupture, and the disability or mortality.

Key words: subarachnoid hemorrhage, intracranial aneurysm, imaging examination