Ruptured basilar tip aneurysm secondary to fibromuscular dysplasia
Sudden onset severe frontal headache, photophobia, nausea and vomiting. Patient distressed and disoriented. History of migraines however pain reported to be dissimilar. Previously well.
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CT Brain (Non-contrast)
Evidence of a large subarachnoid bleed with blood in the Sylvian fissures, frontoparietal regions and in the lateral, third and fourth ventricles. No evidence of cerebellar coning.
There is a 5 x 7 mm aneurysm arising from the terminal part of the basilar artery. No evidence of active bleeding. The terminal cervical ICA has a beaded appearance with a slight aneurysm on the right. Findings compatible with fibromuscular dysplasia.
This case illustrates a large subarachnoid hemorrhage and basilar tip aneurysm in a patient with suspected fibromuscular dysplasia.