PMC8247693_01
Extensive superficial subarachnoid hemorrhage (Fisher grade 3) with wine glass appearance (arrow).
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F1
On D1 of ICU care NCCT brain revealed diffuse, superficial subarachnoid hemorrhage (modified Fisher scale Grade 3) [Figure 1] with evidence of cerebral edema, persistently low GCS (4/15) and WFNS grading of 5 (GCS <7 with deficits).
Cluster type respiratory pattern (bottom tracing) indicated in capnography.
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F2
A cluster type respiratory pattern was noticed on capnography [Figure 2].
Supratentorial diffuse subarachnoid hemorrhage (arrows) with liquefactive necrosis of brain matter with adjacent mass of irregular, dilated vessels (arrowheads).
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F3
Adjacent to the blood clots evidence of pressure effect causing sulci and gyri obliteration with extensive cerebral edema was found [Figure 3].
Adjacent brain parenchyma with liquefactive necrosis on right denoted by black arrows (H and E x100).
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F4
Liquefaction of brain parenchyma was noted in several foci [Figure 4].
(a) Ectatic and fibrous vascular channels without intervening brain parenchyma - black arrows (H and E x400), (b) malformed vascular spaces (blue arrows) with focal calcifications (black arrows) in fibrous wall (H and E x100).
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F5
Histopathological specimens revealed closely packed large cavernous vascular spaces, marginated by thin fibrous tissue with the absence of intervening glial tissue which is compatible with a CCM [Figure 5a and b].