Presentation
Loss of consciousness.
Patient Data
Extensive subarachnoid hemorrhage with blood in the basal cisterns, sylvian fissures, interhemispheric fissure, tentorium cerebelli and all sulci. No intraparenchymal or intraventricular hemorrhage, acute infarction or midline shift is seen.
Aneurysm measuring about 10 x 7 mm, arising from the right internal carotid at the beginning of posterior communicating artery. Morphology of the rest of the circle of Willis is normal.
CT acquired after 7 days of course treatment shows significant deterioration, with extensive subarachnoid hemorrhages, a large hematoma, intraventricular hemorrhages, cerebral edema, and acute infarction. The midline shift to the left is about 12 mm.
Case Discussion
This case demonstrates characteristic features of extensive intracranial hemorrhage with an aneurysm located on the right side of the posterior communicating artery, along with subsequent complications.
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