A Case Report of Aneurysmal Subarachnoid Hemorrhage Complicated by Stanford Type B Aortic Dissection

Aneurysmal Subarachnoid Hemorrhage (aSAH) is a severe condition caused by the rupture of an Intracranial Aneurysm (IA), resulting in bleeding into the subarachnoid space. Aortic Dissection (AD) is a serious vascular emergency characterized by an intimal tear that allows blood to enter the media layer, causing the aortic wall to separate into a true lumen and a false lumen. Both of these conditions are relatively uncommon in clinical practice but represent highly lethal vascular emergencies. Since these two conditions share related pathological mechanisms and exhibit similar clinical symptoms, coupled with conflicting treatment approaches, their coexistence presents an extremely rare and challenging clinical dilemma.

A 60-year-old female patient with aSAH presented with chest pain and chest tightness prior to surgery. The electrocardiogram showed no abnormal conditions. She underwent endovascular coil embolization in the neurosurgery department. However, her chest pain symptoms did not improve after surgery. After thorough examination, the patient was diagnosed with Stanford Type B aortic dissection. The patient underwent thoracic endovascular aortic repair in the cardiac surgery department. Postoperative follow-up at 1 month and 12 months indicated that the patient recovered well.

This study reports the first case of aSAH complicated by Stanford Type B aortic dissection, we present its unique imaging features, and provide key insights into the development and clinical management of this comorbidity.