Presentation
Patient found collapsed whilst hanging up the clothes. GCS 5
Patient Data
Extensive acute subarachnoid hemorrhage, blood present in the basal cisterns, prepontine cistern and in the cerebral sulci bilaterally. There is a sizable intracerebral hematoma centered on the left Sylvian fissure. Breakthrough into the ventricular system with the trace of blood in the third and fourth ventricle and mild midline shift to the right.
There is a giant aneurysm of the horizontal M1-segment of the left middle cerebral artery (MCA).
Case Discussion
This case illustrates the consequences of a ruptured left middle cerebral artery characterized by extensive acute subarachnoid hemorrhage (with blood present in the basal cisterns, prepontine cistern and the cerebral sulci bilaterally) and by massive intracerebral hematoma.