Technique: Non-contrast images through the brain have been obtained.
Findings: Reference is made with previous DSA. Comparison is made with external CT (not shown).
Hyperdense subarachnoid haemorrhage is seen predominantly surrounding the brainstem and extending inferiorly through the foreman magnum surrounding the basilar artery in keeping with site of dissection. Haemorrhage is also seen within the perimesencephalic cisterns, left sylvian fissure, temporal horns of the lateral ventricles, third and fourth ventricles. There has been redistribution of blood products but no evidence of interval bleed.
No subfalcine, tonsillar or uncal herniation.
Right frontal approach EVD terminates inferior to the anterior horn of the left lateral ventricle. Ventricular pattern is stable. No evidence of acute ischaemia.
Conclusion: Extensive subarachnoid haemorrhage in keeping with vertebral and basilar artery dissection. No interval haemorrhage evident.