Table 1. List of published cases of the pSAH sign attributed to infectious etiology: clinical characteristics, neuroimaging findings, lab findings, and outcome.
AMS: altered mental status; CHF: congestive heart failure; CKD: chronic kidney disease; CSF: cerebrospinal fluid; CT: computed tomography; DM: diabetes mellitus; HA: headache; HIV/AIDS: human immunodeficiency virus/acquired immunodeficiency syndrome; HTN: hypertension; RBC: red blood cell; SAH: subarachnoid hemorrhage; WBC: white blood cell
| Publication | Age/sex | Medical comorbidities | Presenting symptoms | Neurological symptoms | Interval between presentation and imaging | CT findings | CSF | Outcome |
| Chatterjee et al., 2003 [6] | 43/F | History of venous thrombosis, severe eczema | Flu-like symptoms | Decreased consciousness | - | Non-contrast CT scan showing increased density within the basal cisterns and along the Sylvian fissures bilaterally | Opening pressure >35 cmH2O, WBC 1510×10^6/L, RBC 160×10^6/L, protein 2291 mg/L. Positive for pneumococcal antigen | Discharged; residual bilateral blindness |
| Given et al., 2003 [7] | 6/M | - | - | - | - | Compression and/or mass effect on the fourth ventricle, effacement of the basal cisterns and cortical sulci, decreased grey-white matter differentiation | - | Death |
| Cucchiara et al., 2004 [8] | 22/M | - | Fever, coma, seizures | Coma, seizures | - | Diffuse sulcal effacement, obliterated basal cisterns, and a dense linear area in the interhemispheric fissure | Leukocytes 44/mm3, with lymphocytic predominance; erythrocytes 3/mm3, without xanthochromia; normal protein and glucose; negative Gram stain | Resolution |
| Hoque et al., 2008 [9] | 50/M | - | HA, confusion, vision loss | Vision loss | 1 hour | CT with and without contrast showed subarachnoid hemorrhage with associated cerebral infarction in the right parietal area | Clear colorless fluid, opening pressure >35 cmH2O, normal glucose, no RBCs. Protein 102 mg/dL. WBC 169/mm3 54% lymphocytes and 40% granulocytes. Cryptococci were detected | Discharged; residual visual acuity bilaterally |
| Coady et al., 2011 [10] | 42/M | HIV/AIDS (CD4 T cell count of 35) | Falls, somnolence, occipital HA | Right lateral gaze palsy, bilateral horizontal and vertical nystagmus | - | Subarachnoid hemorrhage along the cisterns with effacement of the quadrigeminal cisterns | CSF was clear, WBC 2/mm3, RBC 73/mm3, total protein 5 mg/dL. A second tube’s WBC was 1 cell/mm3, and RBC 12 cells/mm3. CSF culture grew Cryptococcus neoformans | Death |
| Lang et al., 2013 [11] | 57/M | HTN | Occipital HA, neck stiffness, confusion, vomiting | Expressive dysphagia | 16 hours | Hyperdense substance in the occipital horns of the lateral ventricles and in the left Sylvian fissure associated with early hydrocephalus | CSF was yellow-green and turbid. Glucose 1.7 mmol/L, protein 8.1 g/L, WBC 2404, RBC 111. Grew pneumococcal meningitis | Discharged; residual Bell's palsy |
| Nakae et al., 2013 [12] | 68/F | Ovarian tumor | HA, fever, neck stiffness, drowsiness | Decreased hearing, decreased vision | 1 month | Iso- to high-density areas within the cortical sulci | Opening pressure 14 cmH2O, WBC 37/mm3 (32 lymphocytes/5 neutrophils), protein 38 mg/dL, glucose 21 mg/dL. Culture yielded Cryptococcus neoformans | Discharged; residual hearing and vision loss |
| Ho et al., 2018 [13] | 83/M | HTN, hyperlipidemia, CHF, Atrial fibrillation on warfarin, DM, CKD on hemodialysis | AMS, emesis | Left gaze preference, left arm and leg in a tonically flexed position with intermittent rhythmic jerks | 4.5 hours | Non-contrast CT revealed diffuse hyperdensity within the basal cisterns, Sylvian fissure, and cerebral sulci bilaterally, concerning diffuse SAH | Nucleated cell count 683 cells/μL, RBC 2180 cells/μL, glucose 69 mg/dL, protein 590 mg/dL, and Gram stain with rare Gram-positive cocci | Death |
| Camacho et al., 2019 [14] | 22/M | Recent methamphetamine use | HA, nuchal rigidity | - | <24 hours | Noncontract brain CT with hyperdense material along the inferior right tentorial leaflet and right brainstem | Cloudy CSF. Opening pressure 48 mmHg. Glucose <10 mg/dL, protein 846 mg/dL, nucleated cell count 21.5×10^9/L, 96% segmented neutrophils. Gram stain grew methicillin-sensitive Staphylococcus aureus | Resolution |