Ruptured aneurysm of supraclinoid internal carotid artery with contained hematoma

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Severe headache

Patient Data

Age: 80 years
Gender: Female

Bilobed out pouching is seen arising from lateral aspect of right supraclinoid internal carotid artery measuring approximately 18 x 16 mm.
Subacute hemorrhage measuring approximately 13 x 25 x 19 mm (AP x TD x CC) is seen at its posterolateral aspect, indenting the right cerebral peduncle, thalamus and medial temporal lobe.
Chronic lacunar infarcts and areas of ischemic demyelination are seen in bilateral periventricular, deep and subcortical white matter.
Convexity sulci and lateral ventricles are prominent, likely age related atrophy.

Case Discussion

Findings are suggestive of ruptured aneurysm of right supraclinoid internal carotid artery with contained subacute hematoma.

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