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Matthew R. Reynolds, Spiros L. Blackburn and Gregory J. Zipfel

after perimesencephalic subarachnoid hemorrhage . Stroke 38 : 1222 – 1224 , 2007 3 Ildan F , Tuna M , Erman T , Göçer AI , Cetinalp E : Prognosis and prognostic factors in nonaneurysmal perimesencephalic hemorrhage: a follow-up study in 29 patients . Surg Neurol 57 : 160 – 166 , 2002 4 Marquardt G , Niebauer T , Schick U , Lorenz R : Long term follow up after perimesencephalic subarachnoid haemorrhage . J Neurol Neurosurg Psychiatry 69 : 127 – 130 , 2000 5 Matsuno H , Rhoton AL Jr , Peace D : Microsurgical

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Homajoun Maslehaty, Athanassios K. Petridis, Harald Barth and Hubertus Maximilian Mehdorn

Neurosurg 23 : 29 – 32 , 1965 2 Andaluz N , Zuccarello M : Yield of further diagnostic work-up of cryptogenic subarachnoid hemorrhage based on bleeding patterns on computed tomographic scans . Neurosurgery 62 : 1040 – 1047 , 2008 3 Barth H , Nabavi A , Stein H , Behnke A , Mehdorn HM : [Perimesencephalic subarachnoid hemorrhage—an independent clinical picture of non-aneurysmatic subarachnoid hemorrhage with a benign course.] . Zentralbl Neurochir 57 : 108 – 112 , 1996 . (Ger) 4 Berdoz D , Uske A , de Tribolet N

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David W. Herzig, Andrew B. Stemer, Randy S. Bell, Ai-Hsi Liu, Rocco A. Armonda and William O. Bank

: Variant deep cerebral venous drainage in idiopathic subarachnoid hemorrhage . Neurol Med Chir (Tokyo) 51 : 97 – 100 , 2011 8 Kurosu A , Suzukawa K , Amo M , Horinaka N , Arai H : Perimesencephalic non-aneurysmal subarachnoid hemorrhage caused by cavernous sinus thrombosis: case report . Neurol Med Chir (Tokyo) 47 : 258 – 260 , 2007 9 Lee J , Koh EM , Chung CS , Hong SC , Kim YB , Chung PW , : Underlying venous pathology causing perimesencephalic subarachnoid hemorrhage . Can J Neurol Sci 36 : 638 – 642 , 2009 10

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Edison P. Valle, Rafael J. Tamargo and Philippe Gailloud

M , Ramos LM , Tanghe HL , Hasan D , : Nonaneurysmal perimesencephalic subarachnoid hemorrhage: CT and MR patterns that differ from aneurysmal rupture . AJNR Am J Neuroradiol 12 : 829 – 834 , 1991 13 Sugahara T , Korogi Y , Nakashima K , Hamatake S , Honda S , Takahashi M : Comparison of 2D and 3D digital subtraction angiography in evaluation of intracranial aneurysms . AJNR Am J Neuroradiol 23 : 1545 – 1552 , 2002 14 Topcuoglu MA , Ogilvy CS , Carter BS , Buonanno FS , Koroshetz WJ , Singhal AB

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Christos Lazaridis, Jeffrey Bodle, Imran Chaudry, Angela Hays and Julio Chalela

hemorrhage . Surg Neurol 69 : 526 – 529 , 2008 5 Hui FK , Tumialán LM , Tanaka T , Cawley CM , Zhang YJ : Clinical differences between angiographically negative, diffuse subarachnoid hemorrhage and perimesencephalic subarachnoid hemorrhage . Neurocrit Care 11 : 64 – 70 , 2009 6 Ingall T , Asplund K , Mähönen M , Bonita R : A multinational comparison of subarachnoid hemorrhage epidemiology in the WHO MONICA stroke study . Stroke 31 : 1054 – 1061 , 2000 7 Korja M , Silventoinen K , McCarron P , Zdravkovic S , Skytthe

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Yuji Matsumaru, Kiyoyuki Yanaka, Ai Muroi, Hiroaki Sato, Takao Kamezaki and Tadao Nose

GJ , Wijdicks EF , Vermeulen M , et al : The clinical course of perimesencephalic nonaneurysmal subarachnoid hemorrhage. Ann Neurol 29 : 463 – 468 , 1991 Rinkel GJ, Wijdicks EF, Vermeulen M, et al: The clinical course of perimesencephalic nonaneurysmal subarachnoid hemorrhage. Ann Neurol 29: 463–468, 1991 9. Rinkel GJ , Wijdicks EF , Vermeulen M , et al : Nonaneurysmal perimesencephalic subarachnoid hemorrhage: CT and MR patterns that differ from aneurysmal rupture. AJNR 12 : 829

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Jose F. Alén, Alfonso Lagares, Ramiro D. Lobato, Pedro A. Gómez, Juan J. Rivas and Ana Ramos

unexplained subarachnoid hemorrhage. J Neurosurg 48: 712–716, 1978 8. Friedman DP : Ruptured aneurysm of the basilar artery simulating nonaneurysmal perimesencephalic subarachnoid hemorrhage. AJR 167 : 283 – 284 , 1996 Friedman DP: Ruptured aneurysm of the basilar artery simulating nonaneurysmal perimesencephalic subarachnoid hemorrhage. AJR 167: 283–284, 1996 9. Gilbert JW , Lee C , Young B : Repeat cerebral pan-angiography in subarachnoid hemorrhage of unknown etiology. Surg Neurol 33 : 19

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Peter F. Morgenstern and Jared Knopman

A 44-year-old woman presented with headache and perimesencephalic subarachnoid hemorrhage (PM-SAH). Initial digital subtraction angiography (DSA) and CT angiography (CTA) showed no underlying pathology ( Fig. 1A ). On Day 9 DSA revealed a 1.7-mm aneurysm of the basilar trunk ( Fig. 1B ), but CTA on Day 14 failed to demonstrate this aneurysm. The aneurysm was clipped via a subtemporal craniotomy. Postoperative DSA confirmed no residual filling ( Fig. 1C ), and the patient recovered well. Fig. 1. A : DS angiogram on admission fails to demonstrate an

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Eric W. Nottmeier, Robert E. Wharen and Naresh P. Patel

: Spinal arachnoid cyst related to a nonaneurysmal perimesencephalic subarachnoid hemorrhage: case report . Neurosurgery 57 : E817 , 2005 10 Valls PL , Naul LG , Kanter SL : Paraplegia after a routine lumbar laminectomy: report of a rare complication and successful management . Neurosurgery 27 : 638 – 640 , 1990 11 Wang MY , Levi AD , Green BA : Intradural spinal arachnoid cysts in adults . Surg Neurol 60 : 49 – 46 , 2003

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, 2002 Lagares A, Gómez PA, Lobato RD, et al: Hemorragia subaracnoidea no filiada: comparación de diferentes patrones de sangrado y evolución a largo plazo. Neurocirugèa 13: 110–119, 2002 5. Marzuardt G , Niebauer T , Schick U , et al : Long term follow up after perimesencephalic subarachnoid hemorrhage. J Neurol Neurosurg Psychiatry 69 : 127 – 130 , 2000 Marzuardt G, Niebauer T, Schick U, et al: Long term follow up after perimesencephalic subarachnoid hemorrhage. J Neurol Neurosurg Psychiatry 69: 127–130, 2000