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Published on: September 25, 2009
Pseudoaneurysm Formation in Intracerebral Hematoma due to Ruptured Middle Cerebral Artery Aneurysm
Motohiro Nomura1, Akira Tamase1, Tomoya Kamide1
1Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Sakae-ku, Yokohama, Japan.
Abstract:
We report the case of a ruptured middle cerebral artery aneurysm that showed pseudoaneurysm formation in an intracerebral hematoma. A 61-year-old man who was taking warfarin complained of dysarthria. Three days later, he was found unconscious, and computed tomography on admission showed subarachnoid hemorrhage and an intracerebral hematoma in the left temporal lobe. Three-dimensional computed tomographic angiography showed an irregular-shaped aneurysm-like cavity extending from the left middle cerebral artery into the hematoma. Intraoperative observation revealed that the aneurysm itself was small and the lesion observed on computed tomography was a pseudoaneurysm that had formed in the hematoma. Pathologic examination of the aneurysm demonstrated that there was a thrombus at its tip. In this report, radiologic characteristics of three-dimensional computed tomographic angiography and etiology of a pseudoaneurysm in an intracerebral hematoma due to aneurysm rupture are discussed.
Insights
A ruptured middle cerebral artery aneurysm led to a pseudoaneurysm within an intracerebral hematoma. This rare complication, observed in a warfarin patient, highlights the importance of advanced imaging for diagnosis.
Area of Science:
- Neurology
- Radiology
- Vascular Surgery
Background:
- Subarachnoid hemorrhage (SAH) and intracerebral hematomas (ICH) are serious neurological conditions.
- Middle cerebral artery (MCA) aneurysms are a common cause of SAH.
- Pseudoaneurysm formation in ICH is a rare but critical complication.
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