{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:33:44Z","timestamp":1790404424656,"version":"4.1.0"},"reference-count":18,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cerebrovasc Dis"],"published-print":{"date-parts":[[2012]]},"abstract":"<b><i>Introduction:<\/i><\/b> Atraumatic and nonaneurysmal sulcal subarachnoid hemorrhage (sSAH) is a rare type of cerebrovascular disease with various etiologies previously reported in small case reports. In this study, we propose to analyze clinical presentations, imaging patterns and etiologies in a large case series of such patients in order to propose a diagnostic workup. <b><i>Methods:<\/i><\/b> We retrospectively analyzed clinical and radiological data of consecutive patients with a diagnosis of atraumatic and nonaneurysmal sSAH, admitted to our institution between 2008 and 2011. All patients had both computed tomography (CT) and magnetic resonance imaging (MRI) as a part of their initial evaluation. <b><i>Results:<\/i><\/b> 30 patients (18 women and 12 men, mean age: 60 years) were identified. The main clinical symptoms at presentation were focal and transient neurological deficit (n = 22) and thunderclap headache (n = 10). Four patients had progressive headache and 4 other had partial or generalized epileptic seizures. MRI abnormalities associated with sSAH were prior hemorrhages, microbleeds, severe leukoencephalopathy and hemosiderosis suggesting cerebral amyloid angiopathy (CAA; n = 9), vasogenic edema in parieto-occipital areas compatible with a posterior reversible encephalopathy syndrome (PRES; n = 3), cortical venous thrombosis (n = 2) and concomitant acute cortical stroke (n = 3). Other underlying causes of sSAH, not diagnosed on MRI, were reversible cerebral vasoconstriction syndrome (RCVS) based on clinical criteria and conventional angiography (n = 4), angiitis diagnosed by skin biopsy (n = 1), vascular malformation diagnosed on CT and digital subtraction angiographies (n = 3), and overanticoagulation (n = 1). Four cases remained unresolved. <b><i>Conclusion:<\/i><\/b> This study confirmed that sSAH is a rare condition related to a wide spectrum of etiologies. Combination of brain MRI and magnetic resonance angiography and eventually digital subtraction angiography allowed the identification of an underlying etiology for 87% of patients. CAA, RCVS and PRES represented more than 50% of the etiological mechanisms. Among older patients, sSAH was mainly related to CAA while in younger patients, RCVS represented the most frequent etiology.<\/jats:p>","DOI":"10.1159\/000339685","type":"journal-article","created":{"date-parts":[[2012,8,8]],"date-time":"2012-08-08T05:40:20Z","timestamp":1344404420000},"page":"147-152","source":"Crossref","is-referenced-by-count":32,"title":["Atraumatic Nonaneurysmal Sulcal Subarachnoid Hemorrhages: A Diagnostic Workup Based on a Case Series"],"prefix":"10.1159","volume":"34","author":[{"given":"P.","family":"Renou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Tourdias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Fleury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Debruxelles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Rouanet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Sibon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2012,8,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1093%2Fbrain%2F124.2.249"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1161%2FSTROKEAHA.111.621847"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1212%2FWNL.0b013e3181d55efa"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1468-1331.2010.03214.x"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.3171%2FJNS.2008.109.12.1034"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1212%2FWNL.56.4.537"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.7326%2F0003-4819-146-1-200701020-00007"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1159%2F000319780"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1159%2F000049149"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1212%2F01.wnl.0000345666.83318.03"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1093%2Fbrain%2Fawl297"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1001%2Farchneurol.2011.68"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1093%2Fbrain%2Fawm256"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1097%2F00004728-200603000-00025"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1259%2Fbjr%2F70065269"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1212%2FWNL.0b013e3181dad605"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1093%2Fbrain%2Fawh379"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1097%2FRCT.0b013e3181f31917"}],"container-title":["Cerebrovascular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/339685","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/339685","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T18:31:20Z","timestamp":1745433080000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000339685"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012]]},"references-count":18,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2012,9,1]]},"published-print":{"date-parts":[[2012,9,7]]}},"URL":"https:\/\/doi.org\/10.1159\/000339685","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.5123722","asserted-by":"subject"}]},"ISSN":["1015-9770","1421-9786"],"issn-type":[{"value":"1015-9770","type":"print"},{"value":"1421-9786","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012]]}}}