{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:25:12Z","timestamp":1782602712656,"version":"3.54.5"},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2008,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The clinical characteristics and overall outcome in patients with spontaneous isolated convexity subarachnoid hemorrhage (SAH) are not well described in the literature. The purpose of this study was to examine the mode of presentation, common origins, radiographic findings, and clinical course in a large case series of such patients.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A retrospective single-center chart review of all patients in whom nontraumatic primary convexity SAH was diagnosed between 2002 and 2007 was performed. Twenty patients were identified and analyzed for presenting symptoms, radiological and laboratory findings, hospital course, and outcome.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>There were 15 women and 5 men in our series, and the mean age was 52 years (range 18\u201386 years). The most common presenting symptom was headache, with 15 patients experiencing it as a chief complaint. Other frequent manifestations included altered mental status (8 patients), focal neurological deficits (7), and seizure (4 patients). An underlying cause of the hemorrhage was identified in 13 cases, whereas the remainder went unresolved. Of the known causes, 5 were due to posterior reversible encephalopathy syndrome, 3 were caused by thrombocytopenia or anticoagulation, and the remainder were isolated cases of lupus vasculitis, drug-induced vasculopathy, postpartum cerebral angiopathy, hypertensive microangiopathy, and Call\u2013Fleming syndrome. All patients with unknown disease origins had favorable outcomes, whereas 8 of 13 patients with an identifiable underlying disorder experienced favorable outcomes.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Spontaneous isolated convexity SAH is rarely caused by aneurysm rupture, has a distinct mode of presentation, and generally carries a more favorable prognosis than that of aneurysmal SAH.<\/jats:p><\/jats:sec>","DOI":"10.3171\/jns.2008.109.12.1034","type":"journal-article","created":{"date-parts":[[2008,11,26]],"date-time":"2008-11-26T17:00:36Z","timestamp":1227718836000},"page":"1034-1041","source":"Crossref","is-referenced-by-count":76,"title":["Spontaneous isolated convexity subarachnoid hemorrhage: presentation, radiological findings, differential diagnosis, and clinical course"],"prefix":"10.3171","volume":"109","author":[{"given":"Daniel","family":"Refai","sequence":"first","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Botros","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell G.","family":"Strom","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin P.","family":"Derdeyn","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"},{"name":"Mallinckrodt Institute of Radiology, and"},{"name":"Department of Neurology, Washington University School of Medicine, Saint Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aseem","family":"Sharma","sequence":"additional","affiliation":[{"name":"Mallinckrodt Institute of Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory J.","family":"Zipfel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"},{"name":"Department of Neurology, Washington University School of Medicine, Saint Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1091034","series-title":"Pediatr Neurol","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/S0887-8994(98)00148-9","article-title":"Posterior leukoencephalopathy syndrome may not be reversible","volume":"20","author":"Antunes","year":"1999"},{"key":"b2-1091034","series-title":"AJNR Am J Neuroradiol","first-page":"9","article-title":"Angiography of primary central nervous system angiitis of childhood: conventional angiography versus magnetic resonance angiography at presentation","volume":"28","author":"Aviv","year":"2007"},{"key":"b3-1091034","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1212\/WNL.55.9.1315","article-title":"Onset seizures independently predict poor outcome after subarachnoid hemorrhage","volume":"55","author":"Butzkueven","year":"2000"},{"key":"b4-1091034","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1161\/01.STR.19.9.1159","article-title":"Reversible cerebral segmental vasoconstriction","volume":"19","author":"Call","year":"1988"},{"key":"b5-1091034","series-title":"AJNR Am J Neuroradiol","first-page":"1676","article-title":"Isolated cortical venous thrombosis presenting as subarachnoid hemorrhage: a report of three cases","volume":"25","author":"Chang","year":"2004"},{"key":"b6-1091034","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"1818","DOI":"10.1016\/S0140-6736(00)03236-0","article-title":"Subarachnoid haemorrhage treated with anticoagulants","volume":"356","author":"Ciccone","year":"2000"},{"key":"b7-1091034","series-title":"AJNR Am J Neuroradiol","first-page":"1038","article-title":"Posterior reversible encephalopathy syndrome: prognostic utility of quantitative diffusion-weighted MR images","volume":"23","author":"Covarrubias","year":"2002"},{"issue":"3 Suppl","key":"b8-1091034","series-title":"Neurol Sci","doi-asserted-by":"publisher","first-page":"S215","DOI":"10.1007\/s10072-004-0289-1","article-title":"Sentinel headache","volume":"25","author":"de Falco","year":"2004"},{"key":"b9-1091034","series-title":"Ann Emerg Med","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.1016\/S0196-0644(89)80059-9","article-title":"Recognition of subarachnoid hemorrhage","volume":"18","author":"Fontanarosa","year":"1989"},{"key":"b10-1091034","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1227\/00006123-198706000-00027","article-title":"Phenylpropanolamine: an over-the-counter drug causing central nervous system vasculitis and intracerebral hemorrhage. 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