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Introduction
Subarachnoid hemorrhage (SAH) is one of the most serious acute neurologic events. Computed tomography (CT) of the brain is the first diagnostic imaging method performed in patients suspected of having a SAH. However, in rare circumstance, a similar appearance may occur in CT imaging in the absence of blood in the subarachnoid space, which has been designated as ‘pseudo-subarachnoid hemorrhage, PSAH’ (1). Although the exact mechanisms remain unknown, severe diffuse brain edema might be associated with PSAH, and it is extremely important to increase the recognition of PSAH and to distinguish it from true SAH.
PSAH has been observed in various severe clinical events, including acute poisoning (2), cardiopulmonary arrest without trauma (3,4) and sudden unconscious and generalized convulsions (5). In these cases, it was reported that the prognoses of patients were all poor and the common characteristics of pathophysiology were internal medicine-refractory diffuse cerebral edema due to anoxic encephalopathy. Recent clinical trials have favored hyperbaric oxygen therapy (HBOT) as a promising therapeutic strategy for adult patients with severe head injury (6,7); however, clinical data on the safety and efficacy of HBOT in the pediatric field, with the exception of acute carbon monoxide poisoning (8), remains scarce. The present case report describes a pediatric case of diffuse brain edema characterized by a radiological appearance of PSAH successfully treated with HBOT.
Case report
A 10 year-old previously healthy boy was admitted to the Yuhuangding Hospital (Yantai, China) with a 2-day history of a fever and headache. The patient...