A case of spontaneous subarachnoid hemorrhage and intraventricular hemorrhage with negative computed tomography angiography findings

Po-Chien Hwa, Yu-Hui Chiu, Liong-Rung Liu, Wen-Han Chang


Brain computed tomography angiography (CTA) is a useful tool for detecting subarachnoid hemorrhage (SAH) and cerebral aneurysms, but less reliably when cerebral aneurysms which are smaller than 2 mm. We present a case of spontaneous SAH and intraventricular hemorrhage (IVH) with negative findings on brain CTA. Due to the clinical presentation and positive neurologic examination, lumbar puncture was performed and xanthochromia of cerebrospinal fluid (CSF) had been noted. Cerebral angiography was performed and showed a small unruptured saccular cerebral aneurysm (<2 mm).