Acute Subarachnoid Hemorrhage as the Initial Presentation of Extensive Cortical and Dural Sinus Venous Thrombosis

Cerebral venous thrombosis (CVT) is an infrequent, potentially fatal disease that is treatable if detected early. An initial presentation with subarachnoid hemorrhage (SAH) is very rare. We report a case of a 40-year old women that presented with superficial subarachnoid hemorrhage in the right convexity of the brain with extensive thrombosis of the deep and superficial venous system. The non-enhanced CT scan, demonstrated increased attenuation of the venous sinuses. Awareness of this presentation of CVT and the importance of the radiologist role to pick up these findings plays an important role in preventing delayed diagnosis and treatment.