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Subarachnoid hemorrhage: ACOM pattern

Case contributed by Peter Mitchell
Diagnosis certain

Presentation

Unconscious - GCS 3.

Patient Data

Age: 55 years
Gender: Female

There is a very large volume of subarachnoid blood evident on non-contrast imaging within the suprasellar cistern and anterior interhemispheric fissure. Local intraparenchymal extension on the left adjacent to the dome and daughter ACOM aneurysm shown on CTA.

Right ACOM aneurysm projecting to left with daughter aneurysm at dome indicating site of intraparenchymal rupture.  First image in stack is post balloon assisted coil embolization.

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