{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:45:54Z","timestamp":1787071554728,"version":"build-2736575974"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>Primary central nervous system (CNS) malignant melanoma is a rare occurrence that can mimic subarachnoid hemorrhage (SAH) on imaging. We present the case of a patient with primary CNS melanoma presenting as an SAH. A 46-year-old man presented with a 2-week history of subacute thunderclap headaches, blurred vision in the left eye, bilateral hearing impairment, and recent weight loss of 10 kg in a year. Noncontrast head computed tomography scan revealed several spotting hyper-attenuations in the brainstem. Magnetic resonance imaging of the head showed hyper-intensity on the T1 sequence with leptomeningeal enhancement at both cerebral convexities, the surface of the brainstem, the superior cerebellum, both facial\/vestibulocochlear nerve complexes, and trigeminal nerves. Cytospin smear of cerebrospinal fluid (CSF) found atypical cells with intracytoplasmic melanin pigment. The patient was operated upon for hydrocephalus, and the pathology result of a surgical piece confirmed the diagnosis of melanoma. Melanoma should be considered in patients with suspected SAH on imaging with nonbloody and nonxantochromatic CSF. A careful cytologic examination of CSF is needed.<\/jats:p>","DOI":"10.4103\/ant.ant_112_0104","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T07:00:16Z","timestamp":1759129216000},"page":"181-183","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Primary Central Nervous System Melanoma Masquerading as Subarachnoid Hemorrhage: A Case Report"],"prefix":"10.4103","volume":"34","author":[{"given":"Yue-Chin","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Neurology, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Liang","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mackay Memorial Hospital, Taipei, Taiwan"},{"name":"Department of Medicine, Mackay Medical College, New Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"e5805","DOI":"10.1097\/MD.0000000000005805","article-title":"Primary cerebral malignant melanoma: A case report with literature review","volume":"96","author":"Tang","year":"2017","journal-title":"Medicine (Baltimore)"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"e1091","DOI":"10.1016\/j.wneu.2019.07.095","article-title":"Primary malignant melanoma of the brain: A population-based study","volume":"130","author":"Puyana","year":"2019","journal-title":"World Neurosurg"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/0090-3019(92)90208-5","article-title":"Primary solitary intracranial melanoma: Case report and review of the literature","volume":"38","author":"Rodriguez y Baena","year":"1992","journal-title":"Surg Neurol"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"e8557","DOI":"10.1136\/bmj.e8557","article-title":"Thunderclap headache","volume":"346","author":"Ducros","year":"2013","journal-title":"BMJ"},{"key":"R5-20260420","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/j.emc.2017.07.001","article-title":"Subarachnoid hemorrhage: Updates in diagnosis and management","volume":"35","author":"Long","year":"2017","journal-title":"Emerg Med Clin North Am"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1177\/0333102420974351","article-title":"Update on headache and brain tumors","volume":"41","author":"Palmieri","year":"2021","journal-title":"Cephalalgia"},{"key":"R7-20260420","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1001\/jama.282.2.175","article-title":"The rational clinical examination. Does this adult patient have acute meningitis?","volume":"282","author":"Attia","year":"1999","journal-title":"JAMA"},{"key":"R8-20260420","doi-asserted-by":"crossref","first-page":"36","DOI":"10.12659\/PJR.889663","article-title":"Intracranial lesions with high signal intensity on T1-weighted MR images \u2013 Review of pathologies","volume":"78","author":"Zimny","year":"2013","journal-title":"Pol J Radiol"}],"container-title":["Acta Neurologica Taiwanica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ANT.ANT_112_0104","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:48:13Z","timestamp":1787068093000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ANT.ANT_112_0104"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ant.ant_112_0104","relation":{},"ISSN":["1028-768X","3050-9173"],"issn-type":[{"value":"1028-768X","type":"print"},{"value":"3050-9173","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2024-02-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-16","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}