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Published on: June 18, 2021
Two cases of ruptured cerebral aneurysms presenting with contralateral hematomas
Prashant Chittiboina1, Hugo Cuellar, Federico Ballenilla
1Department of Neurosurgery, Interventional Neuroradiology Section, Louisiana State University Health Sciences Center, Shreveport, LA 71130-3932, USA.
Emergency Radiology
|September 3, 2010
Summary
Two cases show brain hematoma contralateral to a ruptured posterior communicating artery aneurysm. This includes the first reported instance of a frontal intraparenchymal hemorrhage opposite the aneurysm. Both patients were successfully treated with coil embolization.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Neurology
Background:
- Intracranial aneurysms, particularly those involving the posterior communicating artery (PCoA), are a significant cause of spontaneous subarachnoid hemorrhage (SAH) and intraparenchymal hemorrhage (IPH).
- Hemorrhage typically occurs ipsilaterally to the ruptured aneurysm, making contralateral presentations rare.
Observation:
- Case 1: A 62-year-old woman presented with a large left frontal intraparenchymal hemorrhage (IPH) associated with a right posterior communicating artery (PCoA) aneurysm.
- Case 2: A 58-year-old male presented with a right PCoA aneurysm and a left sylvian subarachnoid hemorrhage (SAH).
Findings:
- The first case represents the initial documentation of a contralateral frontal IPH secondary to a ruptured PCoA aneurysm.
- Both patients underwent successful endovascular coil embolization of the ruptured aneurysms.
- Post-embolization angiograms confirmed successful occlusion and revealed no additional vascular anomalies in either patient.
Implications:
- These cases expand the understanding of potential hemorrhage patterns following PCoA aneurysm rupture.
- Recognition of contralateral hemorrhage is crucial for accurate diagnosis and timely intervention in cerebrovascular emergencies.
- Endovascular treatment offers a viable option for managing these complex presentations.
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