Aneurysmal subarachnoid hemorrhage
The patient comes to the emergency room, reports that while kneeling changing a wheel, has noticed a dizziness followed by loss of consciousness of few seconds long, with sphincter relaxation and skull brain trauma in facial and right temporal regions. Currently presents intense headache.
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Hyperdense subarachnoid space, focused primarily on the right Sylvian fissure, right frontal sulci, basal cisterns with hyperdense expansion in locating the right MCA, suggesting ruptured right MCA aneurysm.
Produces moderate mass effect on the Sylvian fissure extending it, with slight compression of the anterior horn of the right lateral ventricle, minimal subfalcial herniation left, moderate left descending transtentorial herniation.
Also observed small amount of material blade in third and fourth ventricle without associated ventricular dilatation.
No alterations were identified in the brain parenchyma density suggesting ischemic areas.
Theses findings are consistent with acute SAH secondary to ruptured aneurysm of right middle cerebral artery.
4 case question available
This case demonstrates typical appearances of a subarachnoid hemorrhage.