Related Experiment Video
Updated: May 28, 2026
09:14
Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Ultra-early aneurysmal rebleeding and brainstem destruction
Jennifer E Fugate1, Grant W Mallory, Eelco F M Wijdicks
1Division of Critical Care Neurology, Mayo Clinic, Rochester, MN 55905, USA. fugate.jennifer@mayo.edu
Neurocritical Care
|November 3, 2011
Summary
Sudden worsening after subarachnoid hemorrhage (SAH) can be caused by brainstem hemorrhage extension. This case highlights a critical differential diagnosis for rapid neurologic decline in SAH patients.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Secondary neurologic deterioration is a common complication after aneurysmal subarachnoid hemorrhage (SAH).
- Potential causes include rebleeding, hydrocephalus, parenchymal hematoma, and seizures.
Observation:
- A 69-year-old woman presented with thunderclap headache and nausea, diagnosed with SAH via head CT.
- She experienced two episodes of acute unresponsiveness and fixed anisocoria.
- Serial head CTs revealed massive hemorrhage extension into the brainstem and ventricles.
Findings:
- Massive extension of subarachnoid hemorrhage into the brainstem parenchyma.
- Clinical deterioration correlated with CT findings of brainstem involvement.
Implications:
- Hemorrhage extension into the brainstem is a critical cause of sudden deterioration and coma post-SAH.
- This finding is crucial for differential diagnosis, distinguishing it from oculomotor nerve injury.
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