Ruptured anterior communicating artery aneurysm with neurogenic pulmonary edema
Presentation
Found down.
Patient Data
pCXR at admission.
Endotracheal and nasogastric tubes appropriately positioned, non-specific diffuse bilateral consolidation.
CT chest at admission.
Predominantly perihilar consolidation and groud-glass opacity, likely pulmonary edema.
Head CT at admission.
Extensive subarachnoid and mild intraventricular hemorrhage with mildly dilated ventricles, no intraparenchymal hemorrhage or infarction.
Anterior communicating artery aneurysm, shown before (first 2 images) and after (second 2 images) embolization.
Head CT 2 days later.
Evolving blood products, no intraparenchymal hemorrhage or infarct. Anterior communicating artery embolization coils, ventriculostomy catheter.
pCXR 4 days after admission.
New central line tip in the right atrium, mild basilar atelectasis, lungs otherwise clear.
Case Discussion
Successful embolization of a ruptured anterior communicating artery embolism. Neurogenic pulmonary edema usually resolves spontaneously within 3 days.