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Ruptured middle cerebral artery aneurysm

Case contributed by Dr Fabio Macori

Presentation

Patient found collapsed whilst hanging up the clothes. GCS 5

Patient Data

Age: 50 years
Gender: Female

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.

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