Dr Braun's letter raises an interesting aspect of our case presentation that we did not address.Our patient is now seven years postonset of her neurologic difficulty and, to date, has not demonstrated dementia or deafness. She does not seem to fit the clinical picture described for superficial siderosis. Indeed, her only persistent sign of intracranial dysfunction has been nystagmus. We remain at a loss to explain this finding.Walton stated that dizziness, particularly on head movement (not true vertigo), was the only notable symptom of CNS origin in a follow-up of 120 cases of subarachnoid hemorrhage.1 Heidrich found nystagmus in only 3.6% of 300 cases of subarachnoid hemorrhage and stated it had no lateralizing value.2 Patient 5 in Henson and Croft's series of spinal subarachnoid hemorrhage had bilateral papilledema, bilateral sixth cranial nerve palsies, and coarse nystagmus. His CSF pressure was increased. An autopsy revealed an angioma
Caroscio JT, Brannan T, Budabin M, Yahr MD, Huang YP. Siderosis and Subarachnoid Hemorrhage-Reply. Arch Neurol. 1981;38(1):67. doi:10.1001/archneur.1981.00510010093027
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