Acute Aneurysmal Subdural Hematoma: Clinical and Radiological Characteristics.
- Author:
Sung Man PARK
1
;
Young Min HAN
;
Young Sup PARK
;
Ik Sung PARK
;
Min Woo BAIK
;
Ji Ho YANG
Author Information
1. Department of Neurosurgery, Our Lady of Mercy Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea. hymns@medimail.co.kr
- Publication Type:Original Article
- Keywords:
Cerebral aneurysm;
Subdural hematoma
- MeSH:
Aneurysm*;
Aneurysm, Ruptured;
Arteries;
Female;
Hematoma, Subdural*;
Humans;
Intracranial Aneurysm;
Male;
Medical Records;
Pia Mater;
Tomography, X-Ray Computed
- From:Journal of Korean Neurosurgical Society
2005;37(5):329-335
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Acute spontaneous subdural hematoma(SDH) secondary to a ruptured intracranial aneurysm is a rare event. The authors present nine cases with aneurysmal SDH. METHODS: We analyzed nine cases of aneurysmal SDH from 337 patients who underwent treatment for a ruptured aneurysm between January 1998 and May 2004. Clinical and radiological characteristics and postoperative course were evaluated by reviewing medical records, surgical charts and intraoperative videos. RESULTS: The nine patients comprised four males and five females with a mean age of 53years (range 15-67years). The World Federation of Neurosurgical Societies grades on admission were I in one patient, II in two patients, III in five patients and V in one patient. With respect to location, there were four internal carotid-posterior communicating artery(ICA-Pcom) aneurysms, one distal anterior cerebral artery(DACA) aneurysm, one anterior communicating artery and three middle cerebral artery aneurysms. CT scans obtained from the four patients with ICA-Pcom aneurysms revealed SDH over the convexity and along the tentorium, and two of these patients presented with pure SDH without subarachnoid hemorrhage(SAH). In three patients with ICA-Pcom aneurysm, the ruptured aneurysm domes adhered to the petroclinoid fold. In the patient with the DACA aneurysm, the domes adhered tightiy to the pia mater and the falx. CONCLUSION: Ruptured intracranial aneurysm may cause SDH with or without SAH. In the absence of trauma, the possibility of aneurysmal SDH should be considered.
