title: Subarachnoid hemorrhage due to ruptured posterior cerebral artery aneurysm simultaneously associated with multiple remote intracerebral hemorrhages--case report.
abstract: A 61-year-old woman presented with aneurysmal subarachnoid hemorrhage (SAH) associated with multiple remote intracerebral hemorrhages (ICHs). She had undergone microsurgical neck clipping for ruptured right middle cerebral artery aneurysm and ventriculo-peritoneal shunting 16 years previously. Computed tomography revealed SAH predominantly in the basal cistern and ambient cistern, in association with multiple ICHs in the bilateral tegmentum of the brain stem and right caudate nucleus. Digital subtraction angiography revealed an aneurysm at the P(1) segment of the left posterior cerebral artery. The ruptured aneurysm was microsurgically clipped via a left subtemporal approach without complications. Simultaneous occurrence of aneurysmal SAH and multiple remote ICHs is rare. The spatial pattern of the ICHs in the present case is apparently unique.
authors.affiliation: Department of Neurosurgery, Kohnan Hospital, Sendai, Miyagi, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Sonobe
authors.forename: Miki
authors.initials: M
authors.lastname: Fujimura
authors.forename: Hidenori
authors.initials: H
authors.lastname: Endo
authors.forename: Takashi
authors.initials: T
authors.lastname: Inoue
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
mesh_terms: D017542:Aneurysm, Ruptured / Q000150:complications* / Q000503:physiopathology; D015901:Angiography, Digital Subtraction / Q000379:methods; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D008875:Middle Aged; D020769:Posterior Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000473:pathology* / Q000601:surgery*; D013346:Subarachnoid Space / Q000000981:diagnostic imaging / Q000473:pathology