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A 25 year-old man developed the lightening onset of an explosive headache followed by nausea and vomiting.
Axial CT Scans without contrast: Note the bright areas which signify blood in the interhemispheric fissure, basal cisterns, fourth ventricle. Spontaneous subarachnoid hemorrhage is most often caused by a ruptured aneurysm. They usually present with sudden headache, nausea, and vomiting, often associated with signs of increased intracranial pressure. Rarely, an aneurysm may enlarge and present with focal signs from a mass effect, as is the case of a third nerve palsy and an aneurysm arising from the posterior communicating artery.
The Electronic Curriculum is copyrighted 1998, Case Western Reserve University School of Medicine.