CALCIFIC EMBOLUS CAUSING SUBARACHNOID HEMORRHAGE

Abstract

Nonaneurysmal subarachnoid hemorrhage (SAH) accounts for about 15% of spontaneous, nontraumatic SAH and is often characterized by bleeding in distinctive anatomic locations. For example, perimesencephalic SAH is associated with an excellent prognosis and no significant risk of rebleeding, and has been hypothesized to have a venous origin.1,2 SAH in the superficial cortical sulci without blood in proximity to the circle of Willis also suggests a nonaneurysmal source, as most aneurysms develop at circle of Willis branch points. A number of causes of nonaneurysmal nonperimesencephalic SAH have been described, including vascular malformations, various forms of vasculitis, cerebral venous thrombosis, amyloid angiopathy, Moyamoya syndrome, and coagulopathies.1,3 We present a case of a nonaneurysmal nonperimesencephalic SAH following a calcific embolus to the middle cerebral artery, an unusual association. ### Case report. A 51-year-old left-handed man without significant past medical history or recent trauma presented with insidious onset of headache, progressing over 2 days to the worst headache of his life. On the second day, he developed aphasia and mild left-sided weakness …