Ruptured Cerebral Aneurysm Arising From The Anterior Cerebral Artery Presenting As Acute Subdural Hematoma
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We report a case of a ruptured aneurysm arising from the distal anterior cerebral artery with acute subdural hematoma (SDH) but without subarachnoid hemorrhage. A 51-year-old man admitted in a coma following sudden headache but no history of trauma was found in CT to have a massive SDH on the left convexity. Angiography preceding evacuation of the hematoma showing an aneurysm at A2-A3, but we could not confirm whether it had ruptured because of a slight SDH at the interhemispheric fissure in CT. During the first operation, we conducted evacuation only; no brain or vessel damage was noted. Clipping was then applied to the aneurysm to confirm that it had ruptured and caused the SDH. Cases of ruptured aneurysm without subarachnoid hemorrhage are rare. Analysis by angiography is useful in locating the origin of the acute SDH in the presence of a nontraumatic SDH. In a patient with a ruptured aneurysm at the distal anterior cerebral artery with acute SDH, the discrepancy could be shown between the position of the ruptured aneurysm and the center of the SDH.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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