Intracranial Subarachnoid Hemorrhage with Negative Cerebral Angiogram, how to Deal with? Report of SAH due to Spinal Hemangioblastoma and Review of Literature

Diagnosis and surveillance of angiogram-negative subarachnoid hemorrhage (SAH) has been a controversy in neurosurgical literature. A combination of computed tomography angiogram and digital subtraction angiography has been suggested as follow up studies in guidelines. SAH with a spinal pathology is a rare diagnosis, which is challenging under common symptomatology of SAH, such as loss of consciousness. Here, we report an angiogram-negative SAH, who discharged following recovery. In follow-up, he underwent emergent surgery with hemiparesis and the final diagnosis was thoracic cord hemangioblastoma.