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The Diagnostic Dilemma in Delayed Subarachnoid Hemorrhage: A Case Report
Danielle A Bazer1,2, Nicholas Koroneos1, Matthew Orwitz1
1Stony Brook University Hospital, Department of Neurology, Stony Brook, New York.
Introduction:
Radiologically negative subarachnoid hemorrhage (SAH) has a low incidence and is associated with good clinical outcomes.
Case Report:
We present the case of a 44-year-old male with new-onset headaches, which began one week prior while bike riding. At an outside hospital, he had normal computed tomography head and angiogram. He declined a lumbar puncture. Over the following week, the headache was persistent. He lacked meningeal signs. Repeat studies were normal. Lumbar puncture was positive for xanthochromia.
Conclusion:
Radiologically negative SAH should be included in the differential diagnosis of patients presenting with unremitting headache in the setting of recent exercise, despite negative imaging, and meningeal signs.
