Ruptured anterior communicating artery aneurysm with bilateral anterior cerebral artery infarcts
Presentation
Worst headache of life.
Patient Data
Head CT at presentation.
Intraparenchymal hemorrhage right anterior frontal lobe, right corona radiata and genu/rostrum corpus callosum. Anterior left paramedian subarachnoid hemorrhage. Small low density right convexity subdural collection, hygroma versus chronic hematoma. No hydrocephalus or acute infarction.
Angio before/after embo.
The first 3 images show an anterior communicating artery aneurysm, best shown on the third image. In addition, the first and third images show narrowing of both anterior cerebral arteries, best seen on the left, involving the A2 segments (portion of the anterior cerebral artery that originates at the anterior communicating artery extending superiorly to the genu of the corpus callosum). The next 3 images show successful aneurysm coiling.
Head CT 2 days later.
Evolving intracranial hemorrhage. Interval coiling anterior communicating artery aneurysm. New bilateral anterior cerebral artery infarcts.
Case Discussion
Rebleeding and vasospasm following subarachnoid hemorrhage due to a ruptured aneurysm are major sources of morbidity and mortality. In this case, bilateral anterior cerebral artery vasospasm resulted in bilateral anterior cerebral artery territory infarcts.
Unable to process the form. Check for errors and try again.