A young man with a subarachnoid haemorrhage

摘要

A 33-year-old Brazilian man presented with sudden onset severe (his worst ever) occipital headache. It was associated with stiffening of both arms lasting a few seconds, and paraesthesia of both arms lasting about 45 minutes. CT brain was normal. CSF showed 47,000 red cells and was positive for xanthochromia. A digital subtraction angiogram (DSA) was performed, with the left vertebral injection shown in the figures (see Fig. 1).