Acute preretinal hemorrhage as presenting clinical sign of eventually life-threatening subarachnoid hemorrhage

Background To report on a patient with acute preretinal and intraretinal bleedings as first clinical signs of a life-threatening subarachnoid hemorrhage. Patient A 36-year-old, so far healthy woman complained of decreased vision, which had started eight hours before. She presented herself in good general condition. Ophthalmoscopic evaluation showed intraretinal hemorrhages in both eyes and a preretinal hemorrhage in the left eye. During the examination, the patient fainted and suffered generalized seizure. Cranial computed tomography revealed a subarachnoid hemorrhage originating from an internal carotid artery aneurysm. Conclusion Acute intraretinal and preretinal bleedings in apparently healthy patients can be precursors of eventually life-threatening complications of subarachnoid hemorrhages.