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Year : 2019  |  Volume : 14  |  Issue : 2  |  Page : 510-512

Bilateral chronic subdural hematoma presenting with pseudo-subarachnoid hemorrhage sign on computed tomography

1 Department of Neurosurgery, Shima Neurosurgical and Orthopedic Clinic, Kanto Rosai Hospital, Kawasaki, Japan
2 Department of Neurosurgery, Kanto Rosai Hospital, Kawasaki, Japan
3 Department of Neurology, Kanto Rosai Hospital, Kawasaki, Japan

Correspondence Address:
Motohiro Nomura
Department of Neurosurgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki 211-8510
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_11_19

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Background: On rare occasions, cisterns are demonstrated as high-density areas on computed tomography (CT) and misdiagnosed with subarachnoid hemorrhage (SAH). This false-positive finding is called pseudo-SAH. Patients and Methods: From April 2014 to August 2018, a total of 161 patients with chronic subdural hematoma (CSDH) were treated in our hospital. For these cases, the existence of a pseudo-SAH sign on CT was retrospectively examined. Results: One patient with bilateral CSDH showed pseudo-SAH and a further examination to evaluate vascular abnormalities causing true SAH was necessary. In three patients, the Sylvian fissures were demonstrated as high-density areas due to an atherosclerotic middle cerebral artery; however, the condition was not misdiagnosed with SAH. Conclusion: In cases of CSDH, there is a possibility that CT demonstrates a pseudo-SAH sign. In such cases, close examinations to exclude true SAH are mandatory.

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