PMC4216821_01
Initial CT-Head reveals SAH concentrated in the left sylvian fissure with a thickness of > 1.0 mm (Fisher Grade 3).
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Fig1
His initial computed tomography (CT) of the head revealed a thick collection of subarachnoid hemorrhage localized to the left sylvian fissure (Figure 1).
DWI MRI sequence completed once the patient presented with delayed ischemic symptoms. There is evidence of restricted diffusion in DWI with hyperintensity in the ADC map (not shown) in the same left middle cerebral artery vascular territory, indicating early subacute infarction.
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Fig2
A magnetic resonance imaging of the brain revealed restricted diffusion in the left MCA territory consistent with a subacute infarct (Figure 2).
DSA confirming vasospasm in the narrowed M1 and M2 segments (indicated by the arrow) of the left middle cerebral artery.
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Fig3
The patient had a formal (Digital Subtraction Angiography) DSA that confirmed vasospasm of the M1 and M2 segments of the left middle cerebral artery (MCA) (Figure 3).
PMC4216821_02
CT-Head demonstrating diffuse subarachnoid hemorrhage in bilateral basal cisterns which is mainly concentrated in the left sylvian fissure (Fisher Grade 3).
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Fig4
A CT-head was completed which revealed diffuse and thick subarachnoid hemorrhage, which was mainly centered over the left sylvian fissure and convexity (Figure 4).