[A Case of Ruptured Internal Carotid-Posterior Communicating Artery Aneurysm Associated with Acute Subdural Hematoma, Extending from the Interhemispheric Space to the Posterior Fossa].
A 69-year-old woman was admitted to our hospital because of a sudden severe headache without a history of head trauma. CT and MRI revealed an acute subdural hematoma (ASDH) extending from the right interhemispheric space to the posterior fossa bilaterally, with a small amount of subarachnoid hemorrhage that was predominantly localized to the left side of the basal cistern. CT angiogram demonstrated a long protruding ruptured aneurysm at the junction of the right internal carotid and posterior communicating arteries (IC/PC AN) with a posteroinferior projection, associated with a small bleb located near the tentorial edge close to the ipsilateral posterior clinoid process, for which she received clipping surgery. Though rare, IC/PC AN could cause pure or nearly pure ASDH in the above-mentioned distribution. Therefore, in patients with such ASDH, especially without a history of head injury or precise information regarding the situation at the time of onset, urgent imaging evaluation and early intervention are essential to prevent devastating re-rupture events.
Residency Program, National Hospital Organization Nagasaki Medical Center.
Hiroaki
H
Otsuka
Yuhtaka
Y
Fukuda
Shouta
S
Yoshimura
Chika
C
Somagawa
Takeshi
T
Hiu
Tomonori
T
Ono
Ryujirou
R
Ushijima
Keisuke
K
Toda
Keisuke
K
Tsutsumi
D000368:Aged; D017542:Aneurysm, Ruptured / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000473:pathology / Q000601:surgery*; D005260:Female; D020199:Hematoma, Subdural, Acute / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000473:pathology / Q000601:surgery*; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D064847:Multimodal Imaging; D019635:Neurosurgical Procedures; D014057:Tomography, X-Ray Computed