11:58:00 AM
Dr Subhash Kumar, MBBS, MD, DM
49 yrs, M
Seizures on the morning of admission
Vitals stable
No focal deficit
A CT done at admission showed SAH with flocculent surface hematoma in the left anterior frontal region…significantly there was no blood in the basal cisterns
NCCT at admission
Enlarged images of the NCCT
A cerebral DSA was done which showed thrombosis of anterior part of the superior sagittal sinus, partial thrombosis of the inferior sagittal sinus with hypoplastic left transverse and sigmoid sinuses
Right ICA angiogram
Left ICA angiogram
Left and right vertebral angiogram
Right middle meningeal had anomalous origin from right petrous ICA
Left ECA angiogram showed blush from the middle meningeal artery in the region of the thrombosed superior sagittal sinus
Patient was put on heparin after this
NCCT next morning showed significant resolution of the SAH.
Enlarged images of the NCCT
The patient had an uneventful recovery and was discharged in a stable condition, on Warfarin.
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