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True Cortical Saccular Aneurysm Presenting as an Acute Subdural Hematoma
Leonard H Verhey1, Weichen Wang2, Joseph G Adel3
1College of Medicine, Central Michigan University, Mt. Pleasant, Michigan, USA.
World Neurosurgery
|February 7, 2018
Summary
Ruptured intracranial aneurysms can rarely cause pure subdural hematoma without subarachnoid hemorrhage. This case highlights the importance of considering aneurysm rupture in spontaneous subdural hematoma diagnoses.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Radiology
Background:
- Subdural hematoma (SDH) is rarely caused by ruptured intracranial aneurysms, especially without evidence of subarachnoid hemorrhage.
- Pure SDH from a ruptured cortical saccular aneurysm is exceptionally rare, with this report detailing the eighth such case.
Observation:
- A case of pure subdural hematoma secondary to a ruptured true saccular aneurysm of a cortical artery branch was reported.
- Computed tomography (CT) angiography and cerebral angiography were used to delineate the lesion.
- The patient underwent successful surgical treatment including hematoma evacuation and clip ligation.
Findings:
- The patient experienced no neurological deficits six months post-surgery.
- Follow-up CT angiography confirmed no residual or new vascular abnormalities.
- This case underscores the possibility of aneurysmal rupture as an etiology for spontaneous SDH.
Implications:
- Intracranial aneurysm rupture should be considered in the differential diagnosis of spontaneous subdural hematoma.
- Prompt and comprehensive vascular imaging, including cortical vessels, is crucial for accurate diagnosis.
- Early identification and treatment can lead to favorable patient outcomes.
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