title: Transient reactive lymphocytosis associated with acute middle cerebral artery aneurysmal rupture.
abstract: A 78-year-old female with a prior history of migraine and mild hypertension presented to the emergency room with severe headache and mild meningism. The patient had transient significant reactive lymphocytosis, and a computed tomography scan of the head followed by a cerebral angiogram revealed an acute right-sided middle cerebral artery aneurysm rupture. This case illustrates that acute changes in the peripheral blood smear may suggest a more sinister cause for the presentation such as that of a ruptured middle cerebral artery aneurysm, particularly when multiple etiology for the presentation is possible.
authors.affiliation: Department of Medicine, Adams County Memorial Hospital, Friendship, Wisconsin, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Siddiqui
authors.forename: J H
authors.initials: JH
authors.lastname: Esmaili
mesh_terms: D000208:Acute Disease; D000368:Aged; D017542:Aneurysm, Ruptured / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008218:Lymphocytosis / Q000150:complications*