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. 2002 Dec 22;8(4):393-8.
doi: 10.1177/159101990200800408. Epub 2004 Oct 20.

Acute pure spontaneous subdural haematoma from ruptured intracranial aneurysms

A Nozar  1 , D Philippe, P Fabrice, M Silvia, T Marc
Affiliations

Acute pure spontaneous subdural haematoma from ruptured intracranial aneurysms

A Nozar et al. Interv Neuroradiol. .

Abstract

Acute subdural haematoma (ASDH) is rarely caused by an aneurysmal rupture. We report four cases of pure acute subdural haematomas caused by ruptured intracranial aneurysms. Aneurysms were localized in the posterior communicating artery in two cases, in the anterior communicating artery in one case and in the middle cerebral artery in one other case. Possible mechanisms for this type of aneurysmal bleeding are discussed. A good prognosis for these patients can be expected with rapid evacuation of the haematoma (in case of high intracranial pressure and midline structure shift), and treatment of the aneurysm (surgical clipping or endovascular treatment). Our report demonstrates the utility of angiography in the evaluation of nontraumatic acute subdural haematomas. Angiography has to be performed before haematoma evacuation or just after if the patient requires urgent surgery in case of intracranial hypertension. Aneurysms may require surgical clipping or endovascular treatment.

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Figures

Figure 1
Figure 1
CT scan showing a right-sided ASDH with a mass effect.
Figure 2
Figure 2
Left carotid angiogram showing an anterior communicating aneurysm.
Figure 3
Figure 3
CT scan showing a small right-sided ASDH.
Figure 4
Figure 4
Right carotid angiogram showing a posterior communicating aneurysm.
Figure 5
Figure 5
CT scan showing a right-sided ASDH with a moderate mass effect.
Figure 6
Figure 6
Right carotid angiogram showing a posterior communicating aneurysm.
Figure 7
Figure 7
CT scan showing a right-sided ASDH with a mass effect.
Figure 8
Figure 8
Right carotid angiogram showing an aneurysm of the middle cerebral artery.
See this image and copyright information in PMC

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