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Updated: Jun 28, 2026

Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Recurrent perimesencephalic subarachnoid hemorrhage during antithrombotic therapy
H Bart van der Worp1, Susanne Fonville, Lino M P Ramos
1Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3584 Utrecht, The Netherlands. h.b.vanderworp@umcutrecht.nl
Introduction:
In patients with non-aneurysmal perimesencephalic hemorrhage, spontaneous rebleeding does not occur. The lack of reported recurrences may lead to less cautious administration of antithrombotic therapy.
Methods:
Case report.
Results:
A 57-year-old woman with a perimesencephalic pattern of hemorrhage and negative CT angiography was treated with carbasalate calcium and intravenous heparin because of an acute coronary syndrome. Three days after installment of this antithrombotic therapy she experienced a recurrent perimesencephalic hemorrhage leading to hydrocephalus and a decrease in consciousness. She died the same day as a result of ventricular fibrillation.
Conclusion:
In the early phase after perimesencephalic hemorrhage, anticoagulant therapy may lead to rebleeding. The risks and benefits of antithrombotic therapy should be carefully weighed in patients with a perimesencephalic pattern of hemorrhage and negative CT angiography.
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