title: Acute spontaneous subdural hematoma of arterial origin.
abstract: Acute spontaneous subdural hematoma (SDH) of arterial origin is very rare. We report a case of acute spontaneous SDH that showed contrast media extravasation from cortical artery on angiograms. A 58-year-old male patient developed sudden onset headache and right hemiparesis. Brain CT scan demonstrated acute SDH at left convexity. The patient was drowsy mentality on admission. He had no history of head trauma. Cerebral angiography was performed and revealed a localized extravasation of the contrast media from distal cortical MCA branch. After angiography, the patient deteriorated to comatose mentality. Decompressive craniectomy for removal of SDH was performed. We verified the arterial origin of the bleeding and coagulated the bleeding focus. The histological diagnosis was aneurysmal artery. He recovered after surgery with mild disability. In a case of acute spontaneous SDH, the possibility of a cortical artery origin should be considered.
authors.affiliation: Department of Neurosurgery, Pusan National University Yangsan Hospital, School of Medicine, Pusan National University, Yangsan, Korea.
authors.forename: Soon Ki
authors.initials: SK
authors.lastname: Sung
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Dong Wuk
authors.initials: DW
authors.lastname: Son
authors.forename: Sang Weon
authors.initials: SW
authors.lastname: Lee