Transient Ischaemic Attack Mimic Secondary to Acute Convexity subarachnoid haemorrhage
Transient ischaemic attack (TIA) mimics are important to identify, as misdiagnosis can lead to inappropriate management as well as exposing patients to unnecessary risks and costs. Convexity subarachnoid haemorrhage(SAH) has recently been recognised as a cause of recurrent aura-like symptoms and TIA mimic. Recurrent aura-like episodes occur in cerebral amyloid angiopathy (CAA) and this condition has been the cause or presumed cause in the majority of reported cases. It has been postulated that subarachnoid blood triggers cortical spreading depression with subsequent aura. We describe 2 patients who presented with recurrent stereotyped transient neurological symptoms, in the setting of acute convexity SAH. In one patient SAH occurred secondary to central venous sinus thrombosis. In the other, SAH was due to extension of a traumatic subdural haematoma. Amyloid angiopathy is not a necessary precondition for cortical SAH to cause recurrent TIA-like episodes.