title: [Dissecting aneurysm of the middle cerebral artery (M1-2 portion) with subarachnoid hemorrhage: a case report].
abstract: We report a SAH case of a ruptured dissecting aneurysm of the middle cerebral artery following parietooccipital subcortical hemorrhage. A 68-year-old woman was admitted to our hospital, complaining of headache. On admission she was alert with left homonymous hemianopsia. A CT scan disclosed subcortical hemorrhage in the right parieto-occipital lobe. An angiogram revealed no abnormal vessels. Seven days after admission, she suddenly lapsed into unconsciousness with left hemiparesis. A CT scan demonstrated subarachnoid hemorrhage with a right sylvian hematoma. A second angiogram revealed fusiform dilatation of the M2 branches and aneurysmal dilatation at the M1-M2 bifurcation. Following conservative therapy, she died 21 days after admission. The relationship between subcortical hemorrhage and the subsequent subarachnoid hemorrhage was not certain. We discuss and review the treatment of a dissecting aneurysm of the middle cerebral artery.
authors.affiliation: Department of Neurosurgery, Hachinohe City Hospital, 1, Tamukai, Bishamondaira, Hachinohe, Aomori 031-8555, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ono
authors.forename: T
authors.initials: T
authors.lastname: Kawamura
authors.forename: J
authors.initials: J
authors.lastname: Ito
authors.forename: S
authors.initials: S
authors.lastname: Kanayama
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D013345:Subarachnoid Hemorrhage / Q000209:etiology*