Left middle cerebral artery aneurysm with massive intracranial hemorrhages
Presentation
Severe headache, vomiting followed by sudden loss of consciousness.
Patient Data
Extensive brain hemorrhage with intracerebral, intraventricular and subarachnoid components seen.
Large area of vasogenic edema with effacement of the sulci and crowded foramen magnum seen.
There is rightward midline shift
CTA showed a left sided MCA aneurysm in the M1 segment, containing a focus of calcification.
Selective left common carotid arteriogram, superselective, left ICA arteriogram, confirms the presence of large bilobed aneurysm arising from the left M1.
Case Discussion
This is a massive brain hemorrhage with intracerebral, intraventricular and subarachnoid components. The size of hemorrhage mandates looking for an aneurysm, in this case, it was obvious in the M1 segment of the left MCA.