Clinical Manifestations, Imaging Patterns, and Etiologies of Cortical Subarachnoid Hemorrhage

  Objective  To summarize the clinical manifestations, imaging patterns, and etiologies of cortical subarachnoid hemorrhages (cSAH).

  Methods  The clinical data and imaging findings of 8 cSAH patients who were treated at our department from September 2007 to December 2011 were retrospectively analyzed.

  Results  Among these patients, there were four women and four men aged 21-78 years. Seizure was the most common symptom, whereas headache was unusual. Cranial CT showed linear hyperdensities localized at one or more cortical sulci at the convexity of the brain, especially in the central sulcus of the parietal lobe. The known etiologies of 5 cases included cortical venous thrombosis (n=2), venous sinus thrombosis (n=1), cerebral amyloid angiopathy (n=1), and vasculitis (n=1).

  Conclusions  cSAH is an important subtype of nonaneurysmal subarachnoid hemorrhage with diverse etiologies. Cortical venous thrombosis appears to be a common cause in young patients, while cerebral amyloid angiopathy may be a more frequent cause in old patients.