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The first CT in a SAH: a picture tells a story
  1. Hilda Guerra1,
  2. Arnoley Abcejo2,
  3. Kevin Gobeske3,
  4. EFM Wijdicks3
  1. 1 Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
  2. 2 Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, USA
  3. 3 Department of Critical Care Neurology, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Hilda Guerra, Department of Neurology, 200 First Street SW, Rochester, MN 55905, USA; hguer2{at}


Finding the cause of acute neurological deterioration in the hours following aneurysmal subarachnoid haemorrhage remains challenging. The presence of blood casts in the ventricles proves that deterioration is secondary to acute hydrocephalus and prompts immediate external ventricular drain placement.

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  • Contributors HG, AA, KG and EFMW were involved in drafting and revising the manuscript for content including medical writing for content, study concept and design, analysis and interpretation of data, and acquisition of data.

  • Competing interests None declared.

  • Patient consent Not obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed. This paper was reviewed by Tom Hughes, Cardiff, UK.

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