Convexal subarachnoid hemorrhage presenting as transient focal neurological episodes: A case report and literature review

doi:10.3969/j.issn.1004-583X.2026.03.010

Abstract

Abstract:

Objective To investigate the clinical and imaging characteristics of convexal subarachnoid hemorrhage presenting as transient focal neurological episodes. Methods We report one patient admitted to the Department of Neurology, Hebei General Hospital, who presented with transient focal neurological episodes and was found to have convexal subarachnoid hemorrhage. The patient's clinical presentation and imaging findings were analyzed, and the relevant literature was reviewed. Results The patient was a 60-year-old man who presented to hospital after awakening with speech impairment and left-hand clumsiness for 2 hours. Head CT and MRI demonstrated a deep right frontoparietal cerebral infarction and right-sided convexal subarachnoid hemorrhage. During hospitalization he intermittently developed rightward deviation of the oral commissure accompanied by numbness and stiffness of the tongue, slurred speech, subjective pharyngeal tightness and difficulty swallowing, and a migrating electric shock-like sensation in the upper limb from the fingertips to the upper arm. These episodes lasted several minutes and resolved spontaneously; symptoms were controlled with oxcarbazepine. Conclusion When patients with convexal subarachnoid hemorrhage develop brief, stroke-like neurological episodes, clinicians should consider transient focal neurological episodes in the differential diagnosis to improve diagnostic accuracy.

Key words: subarachnoid hemorrhage, transient focal neurological episodes, clinical features

CLC Number:

R743.35

Yang Kaiqi, Tang Yasai, Sun Nan, XiaoYining , Lv Peiyuan, Dong Yanhong. Convexal subarachnoid hemorrhage presenting as transient focal neurological episodes: A case report and literature review[J]. Clinical Focus, 2026, 41(3): 254-258.

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URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2026.03.010

https://www.lchc.cn/EN/Y2026/V41/I3/254

Figures/Tables 6

Fig.1 Skull CT

Fig.2 Skull DWI

Fig.3 Skull SWI

Fig.4 Skull MRI

Fig.5 Skull MRV

Fig.6 Dynamic electroencephalogram

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