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Case Reports
. 2012:3:39.
doi: 10.4103/2152-7806.94287. Epub 2012 Mar 24.

Subdural hematoma of the posterior fossa due to posterior communicating artery aneurysm rupture

Myoung Soo Kim  1 , Jong Rak Jung, Sang Won Yoon, Chae Heuck Lee
Affiliations
Case Reports

Subdural hematoma of the posterior fossa due to posterior communicating artery aneurysm rupture

Myoung Soo Kim et al. Surg Neurol Int. 2012.

Abstract

Background: We describe an unusual presentation of a ruptured aneurysm of the posterior communicating artery with an acute subdural hematoma (SDH) located in the posterior fossa. We also reviewed the literature, focusing on the location of this intracranial hematoma.

Case description: An 83-year-old woman was admitted to our institution with recent sudden headache and dizziness. Magnetic resonance imaging showed a thin collection of blood in the subdural space adjacent to the clivus, along the wall of the posterior fossa, and at the cervical spine level. A right posterior communicating artery aneurysm was diagnosed using computed tomography angiography and digital subtraction angiography. The aneurysm had two lobes, one of which was attached to the right dorsum sellae. The aneurysm was occluded by stent-assisted coil embolization. The patient was discharged 3 weeks after admission with absence of neurological deficit.

Conclusion: A ruptured aneurysm of the posterior communicating artery may cause an acute SDH.

Keywords: Aneurysm; posterior fossa; subdural hematoma.

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Figures

Figure 1
Figure 1
Magnetic resonance imaging performed 13 days after the symptom onset. (a) T2-weighted axial image at the mid-pons level demonstrating a thin blood collection adjacent to the clivus and both petrous bones. (b) T1-weighted axial image at the lower medulla level showing a thin blood collection at the retroclival area. (c) T1-weighted sagittal image showing a thin blood collection located in the retroclival and the dural lining along the occipital bone
Figure 2
Figure 2
Computed tomography-angiography performed 15 days after ictus demonstrated the presence of an aneurysm with two lobes. One lobe was directed in an inferior–posterior manner, whereas the other exhibited an inferior–medial orientation and was attached to the right dorsum sellae
Figure 3
Figure 3
Postembolization cerebral angiography (a: antero-posterior view, b: lateral view) demonstrated good embolization
See this image and copyright information in PMC

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