"Vasospasm Mimic" After Aneurysmal Subarachnoid Hemorrhage.

BACKGROUND

Secondary brain injuries, such as delayed cerebral infarction (DCI), are the leading causes of disability after subarachnoid hemorrhage (SAH). Detecting DCI may be challenging, especially for patients presenting an altered level of consciousness.

CASE DESCRIPTION: We describe herein the case of a patient who developed acute hemiplegia 4 days after SAH, with raised blood flow velocities on transcranial Doppler, compatible with vasospasm. Finally, full work-up, using computed tomography (CT) scan with perfusion CT and continuous electroencephalography, was consistent with nonconvulsive seizures.

CONCLUSIONS

Multiple secondary complications (DCI, seizures, hydrocephalus) may occur after SAH but are clinically difficult to diagnose. A multimodal evaluation (transcranial Doppler, CT or magnetic resonance imaging, electroencephalography) is useful in order to detect and treat late complications.