[Subdural hematoma following rupture of an aneurysm]

Subdural hematomas are to be expected in about 3% of ruptured intracranial aneurysms. One third of these bleedings causes rapid deterioration as do subdural hematomas of traumatic origin. Otherwise they will show a prolonged or asymptomatic course. On hand of 8 own cases and 51 comparable cases of literature the symptomatology, diagnostic difficulties and the indication for surgery are pointed out. We could show that in more than 70% subdural hematomas in association with bleeding aneurysm are due to aneurysms of the internal carotid artery or the middle cerebral artery. ICA aneurysms are mostly right-sided in these cases and there is a clearly increased susceptibility of women. The possible mechanisms of occurrence of this kind of subdural hemorrhage are discussed.