Subarachnoid Hemorrhage in Perivascular Spaces Mimicking Brainstem Hematoma

Enlarged perivascular spaces and small diffusion-weighted lesions in intracerebral hemorrhage

“…Previous reports support the notion that blood can extend into the perivascular spaces following subarachnoid and intracerebral hemorrhages. 13,14,26,27 Our finding that larger ICH volume is associated with SA-DWIL is in agreement with previous reports. 4 A combination of local compression of the hematoma, cytotoxic injury, and inflammation ensues after ICH.…”

Bleeding of Perivascular Spaces in Midbrain of a Young Patient With Head Trauma

“…Ozturk et al confirmed that, comparing MR signal intensity of PVSs and the intensity of subarachnoid spaces [2]; they found that the mean signal intensity value of PVSs was statistically significantly lower than the intensity of the cerebrospinal fluid both in the subarachnoid space and in ventricles. In literature, there are a few reports exhibiting SAH and intracerebral hematomas extending to the PVSs by leakage of the leptomeninges that surround arteries [3][4]. In this report, we show a case in which the revealed blood is only inside the PVSs; indeed, we have not found any evident sign of SAH or intracerebral hematoma, which could have extended to the PVSs.…”

“…According to Hutchings and Weller [1] and Oztürk and Aydingoz [2], perivascular spaces (PVSs) surrounding the walls of arteries, arterioles, and venules do not directly communicate with subarachnoid spaces. There are a few reports exhibiting subarachnoid hemorrhage (SAH) and intracerebral hematomas extending to the PVSs by leakage of the leptomeninges that surround arteries [3][4]. A review discussed the role of mild traumatic brain injury as a cause of Virchow-Robin spaces (VRSs) pathological enlargement [5].…”