Pediatric Subarachnoid Hemorrhage

  • Etiology: Trauma, aneurysm rupture
  • Imaging:
    — Faint collections of hemorrhage in the subarachnoid space between arachnoid membrane and pia mater
    — Often associated with subdural hematoma and cerebral contusion
  • Note: Most common location for missed subarachnoid hemorrhage is in the interpeduncular cistern
  • DDX:
  • Complications: Vasospasm and stroke
  • Treatment:
  • Clinical:

Radiology Cases of Subarachnoid Hemorrhage

Radiology Cases of Subarachnoid Hemorrhage Due to Trauma

CT of cerebral edema and subarachnoid hemorrhage
Axial CT without contrast of the brain shows diffuse low density through the bilateral cerebral hemispheres (anteriorly) with a normal density cerebellum (posteriorly) that appears relatively hyperdense when compared to the cerebral density. Subarachnoid hemorrhage was also seen bilaterally in the basal cisterns.
CT of subarachnoid hemorrhage, intraventricular hemorrhage and diffuse cerebral edema
Axial CT without contrast of the brain shows acute hemorrhage around the Circle of Willis and brainstem (left) and in the posterior horns of the lateral ventricles bilaterally (right). There is also loss of the cortical sulci and basilar cisterns.

Radiology Cases of Subarachnoid Hemorrhage Due to Ruptured Giant Intracranial Aneurysm

CT and CT angiogram of giant intracranial aneursym
Axial CT without contrast of the head (above) shows a round mixed density lesion just to the right of the third ventricle along with diffuse subarachnoid hemorrhage and cerebral edema. Axial (below left) and sagittal (below right) CT angiogram shows the lesion to arise from the A1 segment of the right anterior cerebral artery.