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Mesencephalic infarction due to vasospasm after non-aneurysmal perimesencephalic haemorrhage
  1. Stephan H Goedee1,
  2. Menno Sluzewski2,
  3. Cees C Tijssen1
  1. 1Department of Neurology, St Elisabeth Hospital, Tilburg, The Netherlands
  2. 2Department of Neuroradiology, St Elisabeth Hospital, Tilburg, The Netherlands
  1. Correspondence to Cees C Tijssen, Department of Neurology, St Elisabeth Hospital, PO Box 90151, Tilburg 5000 LC, The Netherlands; c.tijssen{at}elisabeth.nl

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Introduction

Non-aneurysmal perimesencephalic haemorrhage accounts for a small number of subarachnoid haemorrhages.1 It is generally benign in its course and prognosis, although occasional patients develop hydrocephalus and seizures; vasospasm is rare.1 We describe a patient with perimesencephalic haemorrhage who developed delayed vasospasm and subsequent mesencephalic infarction.

Case report

A 62-year-old man presented with sudden intense headache. He had peripheral arterial occlusive disease, myocardial infarction and chronic kidney disease. Neurological examination was normal. CT scan of head showed subarachnoid haemorrhage in the typical distribution of perimesencephalic haemorrhage (figure 1A). CT angiography showed no …

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