Huge Intramural Hematoma in a Thrombosed Middle Cerebral Artery Aneurysm: A Case Report.
10.7461/jcen.2015.17.3.234
- Author:
Hak Jin KIM
1
;
Sang Won LEE
;
Tae Hong LEE
;
Young Soo KIM
Author Information
1. Department of Neurosurgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea. md@medimail.com
- Publication Type:Case Report
- Keywords:
Hematoma;
Cerebral aneurysm;
Therapeutic embolization;
Dissection;
Middle cerebral artery
- MeSH:
Aneurysm;
Aneurysm, Dissecting;
Angiography;
Brain;
Cerebrospinal Fluid;
Embolization, Therapeutic;
Female;
Headache;
Hematoma*;
Humans;
Intracranial Aneurysm*;
Liver Cirrhosis;
Magnetic Resonance Imaging;
Middle Aged;
Middle Cerebral Artery*;
Subarachnoid Hemorrhage;
Temporal Arteries;
Thrombocytopenia
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2015;17(3):234-238
- CountryRepublic of Korea
- Language:English
-
Abstract:
We describe a case of a huge intramural hematoma in a thrombosed middle cerebral artery aneurysm. A 47-year-old female patient with liver cirrhosis and thrombocytopenia presented to the neurosurgical unit with a 5-day history of headache and cognitive dysfunction. Magnetic resonance imaging and computed tomography of the brain showed a thrombosed aneurysm located in the right middle cerebral artery with a posteriorly located huge intramural hematoma mimicking an intracerebral hematoma. Imaging studies and cerebrospinal fluid analysis showed no evidence of subarachnoid hemorrhage. Angiography showed a partially thrombosed aneurysm at the origin of the right anterior temporal artery and an incidental aneurysm at the bifurcation of the right middle cerebral artery. Both aneurysms were embolized by coiling. After embolization, the thrombosed aneurysmal sac and intramural hematoma had decreased in size 4 days later and almost completely disappeared 8 months later. This is the first reported case of a nondissecting, nonfusiform aneurysm with a huge intramural hematoma, unlike that of a dissecting aneurysm.
