A report of nontraumatic cortical subarachnoid hemorrhage and subsequent management

Report a case of cortical subarachnoid hemorrhage (cSAH) and discuss its management.

A 66-year-old woman presents with acute onset left arm numbness and weakness. Initial head CT shows small hyperdensity in sulci typical for cSAH. Extensive workup with MRI, lumbar puncture and blood tests is performed. No signs of infection, vascular malformations, thrombosis or cancer are found. At outpatient follow-up, she is diagnosed with cSAH secondary to amyloid angiopathy. She is treated with gabapentin.

Diagnosis of cSAH is challenging given its subtle findings, and management is empiric as there are only a few case series in literature.