Pseudosubarachnoid hemorrhage

Area of Science:

• Neurology
• Radiology
• Emergency Medicine

Background:

• Post-cardiac arrest imaging is crucial for medical decision-making and family communication.
• Accurate interpretation of neuroimaging is vital in critical care settings.

Observation:

• A patient experiencing in-hospital cardiac arrest underwent imaging revealing diffuse bilateral subarachnoid hemorrhage.
• Subsequent advanced neuroimaging (MRI) and autopsy findings did not confirm the initial hemorrhage report.

Findings:

• The initial imaging finding was determined to be a pseudosubarachnoid hemorrhage.
• This false positive finding is associated with diffuse cerebral edema, often linked to hypercarbia or severe acute brain injury.

Implications:

• Clinical correlation is essential when interpreting neuroimaging in post-cardiac arrest patients.
• Understanding pseudosubarachnoid hemorrhage can prevent misdiagnosis and guide appropriate patient management.
• This case underscores the need for careful evaluation of imaging findings in the context of severe neurological injury.