Presentation
Headache, vomiting, vertigo.
Patient Data
On the non-contrast series, we see blood in the ventricles, both parietal sulci, and the prepontine and pontocerebellar cisterns. The left internal carotid artery is dilated.
CT angiography shows small dilatations of the basilar artery and right cerebral posterior artery, and a larger one of the left internal carotid artery.
The third and fourth series are MIP reconstructions, in which the arterial vessels are more easily appreciated.
Case Discussion
The subarachnoid hemorrhage, observed on the non-contrast series, may have an aneurysmal rupture as source. A left internal carotid artery aneurysm was suspected on the non-contrast series; two further small aneurysms were found on CT angiography.
We do not know which aneurysm was bleeding; the patient was transferred to another unit for digital subtraction angiography.