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Abstract Details

Acute Multifocal Atraumatic Convexity Subarachnoid Hemorrhage
Cerebrovascular Disease and Interventional Neurology
P13 - Poster Session 13 (5:30 PM-6:30 PM)
4-004

To elucidate the incidence and etiology of acute multifocal atraumatic convexity subarachnoid hemorrhage (cSAH). 

Multifocal convexity subarachnoid hemorrhage has generally been described in the setting of traumatic brain injury, however, has been reported in the absence of trauma in conditions such as reversible cerebral vasoconstriction syndrome (RCVS). We studied the incidence of multifocal cSAH and its clinical features in a single-center retrospective cohort.  

 

 

 

We analyzed our single-center retrospective database of nontraumatic cSAH from 2015-2018.  cSAH was defined as blood in one or more sulci in the absence of trauma; patients with blood in the cisterns or Sylvian fissure were excluded.  Multifocal location was defined as hemorrhage in one or more lobes. Clinical and neuroimaging data were collected.  
Of 70 patients, there were 13 cases of multifocal cSAH, occurring in 18.6% of all cases. Mean age was 58.3 (SD = 14.7). 11 patients were female.  Seven patients had RCVS, two had cerebral amyloid angiopathy (CAA), three had intrinsic coagulopathy, and one patient had endocarditis as the etiology of multifocal cSAH.  Headache was the most common complaint, in eight patients. 6 patients were discharged home after hospitalization.  
Multifocal cSAH occurs in approximately 18.6% of all cSAH and can occur in the absence of trauma.  In our larger cohort of all cSAH, CAA was the most common cause; however, multifocal cSAH is more commonly caused by RCVS.  Clinicians should be aware that multifocal cSAH can occur in the absence of trauma, and may be a harbinger of RCVS, particularly in young patients with thunderclap headache.  
Authors/Disclosures
Katarina B. Dakay, DO
PRESENTER 		No disclosure on file
Katarina B. Dakay, DO No disclosure on file
Ali Mahta, MD (Brown University) Dr. Mahta has received research support from Brown University Health.
Karen L. Furie, MD (RIH/Alpert Medical School of Brown Univ) The institution of Dr. Furie has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen/BMS. Dr. Furie has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for BMJ/JNNP. The institution of Dr. Furie has received research support from NINDS.
Shadi Yaghi, MD (Hackensack Meridian Health) Dr. Yaghi has nothing to disclose.
Shawna M. Cutting, MD, FÂ鶹´«Ã½Ó³»­ The institution of Dr. Cutting has received research support from Genentech.