title: Subarachnoid hemorrhage from dissecting aneurysm of the posterior communicating artery.
abstract: A 36-year-old woman on chronic hemodialysis presented with sudden onset of headache and deterioration of consciousness. She was sent to our hospital on day 1, with subarachnoid hemorrhage. Cerebral angiography showed pearl and string sign on the left posterior communicating artery, which was consistent with a diagnosis of hemorrhage from a dissecting aneurysm of the left posterior communicating artery. She underwent parent artery occlusion via endovascular treatment on day 2. Although cone beam computed tomography before embolization showed a perforator from the lesion, there were no ischemic lesions on diffusion-weighted imaging after the procedure. She was discharged without any neurological deficits. It is important to recognize that dissecting aneurysm of the posterior communicating artery is one cause of subarachnoid hemorrhage. We also discuss the utility of cone beam computed tomography in formulating the treatment plan for such patients.
authors.affiliation: Department of Neurosurgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan. Electronic address: kadosan0313@ybb.ne.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kadooka
authors.affiliation: Department of Neurosurgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Neurosurgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Shimada
authors.affiliation: Department of Neurosurgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
authors.forename: Hiromu
authors.initials: H
authors.lastname: Hadeishi
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D002533:Cerebral Angiography; D054893:Cone-Beam Computed Tomography; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome
keywords: Cone beam computed tomography; Dissecting aneurysm; Endovascular treatment; Posterior communicating artery; Subarachnoid hemorrhage