Published in:
01-08-2017 | A day in the life of a fellow
Ruptured MCA Aneurysm Presenting as Intracerebral Hemorrhage
Published in: Neurocritical Care | Issue 1/2017
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A 75-year-old normotensive woman presented with thunderclap headache. CT revealed a large putaminal hemorrhage with temporal lobe extension (Fig. 1). Family history was notable for aneurysmal subarachnoid hemorrhage. Blood pressure on admission and throughout hospitalization was normal. Echocardiogram showed no LV hypertrophy and renal function was normal, excluding hypertensive nephropathy. In the context of normotension, lack of hypertensive risk factors, temporal lobe extension, and family history, CT angiogram was performed and revealed a ruptured middle cerebral artery aneurysm (Fig. 2).
Fig. 1
Head CT showing large, dissecting right intraparenchymal hemorrhage centered in the right putamen with notable temporal lobe extension and an estimated volume of 45 cm3
Fig. 2
CT angiography demonstrating right MCA aneurysm, measuring 5.8 × 6.2 × 5.1 mm
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