Acute subdural hematoma without subarachnoid hemorrhage due to ruptured intracranial aneurysm--case report

A 54-year-old female presented with acute subdural hematoma secondary to rupture of an intracranial aneurysm. She was admitted with acute onset of severe headache, nausea, and vomiting. There was no past history of head trauma. Computed tomography demonstrated a left subdural hematoma with extension along the tentorium in the absence of subarachnoid or intraparenchymal hemorrhage. Angiography revealed an aneurysm of the internal carotid-posterior communicating artery which was oriented posterolaterally. Uneventful clipping was performed and the patient was discharged from hospital without neurological deficits. The possibility of aneurysmal subdural hematoma should be considered in the absence of trauma.