Interhemispheric subdural hematoma caused by a ruptured internal carotid artery aneurysm: case report.
BACKGROUND
Interhemispheric subdural hematoma (ISH) usually occurs after head trauma; nontraumatic ISH is extremely rare.


METHODS
The authors describe a 62-year-old male presenting with severe headache and ptosis on the left side. Computed tomography (CT) and magnetic resonance imaging disclosed a hematoma in the interhemispheric subdural space without subarachnoid hemorrhage. Cerebral angiography revealed an aneurysm arising from the left internal carotid-posterior communicating artery (IC-PC) junction. The patient underwent emergency clipping of the aneurysm and was discharged without neurological deficit.


CONCLUSIONS
Ruptured aneurysms resulting in ISH without subarachnoid hemorrhage have been reported in only a few cases; this is the second case to describe the association of a ruptured IC-PC aneurysm with an ISH. The etiology of ISH formation due to ruptured aneurysms and the diagnosis are discussed.
Ishikawa
E
E
Departments of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan.
Sugimoto
K
K
Yanaka
K
K
Ayuzawa
S
S
Iguchi
M
M
Moritake
T
T
Kobayashi
E
E
Nose
T
T
D017542:Aneurysm, Ruptured / Q000175:diagnosis* / Q000601:surgery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002533:Cerebral Angiography; D007839:Functional Laterality; D006408:Hematoma, Subdural / Q000209:etiology* / Q000601:surgery; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D014057:Tomography, X-Ray Computed