Sudden-onset Neck Pain, Quadriparesis, and Altered Sensorium: An Unusual Presentation of Subarachnoid Hemorrhage

摘要

Introduction: Patients with subarachnoid hemorrhage (SAH) epitomize the challenges faced by emergency physicians. SAH is uncommon, presenting features are extremely varied, and mis-diagnosis can result in significant morbidity and mortality. Prompt diagnosis and treatment improves outcome. We report an unusual presentation of SAH. Case Presentation: A 60-year-old White woman presented to the emergency department after sudden-onset neck pain, transient quadriparesis, and global sensory disturbance. Initial imaging of the spine revealed no acute abnormalities. Transfer to a regional neurosurgical unit for further investigation and management revealed aneurysmal SAH. The patient subsequently underwent endovascular coiling with a good clinical outcome. Conclusions: We consider this patient to be the first documented case of transient quadriparesis and global sensory disturbance associated with sudden-onset neck pain secondary to SAH. A high index of suspicion for SAH should be maintained when confronted with patients presenting with sudden-onset neck pain and unusual neurological symptoms. Early consideration, appropriate investigation, and management improves outcome in this potentially devastating condition.