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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(02): 418-420
DOI: 10.4103/ajns.AJNS_337_19
Case Report

Fatal subarachnoid hemorrhage: A rare presentation of ruptured A2 dissecting aneurysm

Shigeomi Yokoya
Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga
,
Ayaka Ogata
Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga
,
Akihiko Hino
Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga
,
Sho Nishii
Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga
,
Yukihiro Goto
Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga
,
Hideki Oka
Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga
,
Naoto Shiomi
Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga
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Anterior cerebral artery dissection (ACAD), especially simultaneously presenting with subarachnoid hemorrhage (SAH) and cerebral infarction (CI), is rare. Only a few cases of severe SAH due to ACAD have been reported. Herein, we present an unusual case of severe SAH with simultaneous CI caused by ACAD. A 56-year-old male was brought to our hospital for severe disturbance of consciousness. Head computed tomography (CT) disclosed SAH with intracerebral hematoma. We suspected ruptured anterior communicating artery saccular aneurysm on CT angiography. Emergency craniotomy was performed to avoid cerebral herniation which confirmed the ruptured ACAD of right A2. The dissecting site was treated by wrapping with a Goretex sheet. ACAD of A2 may present with a severe hemorrhagic event.

Key-words:

A2 dissecting aneurysm - fatal subarachnoid hemorrhage - Goretex sheet - wrapping

Financial support and sponsorship

Nil.




Publication History

Received: 14 November 2019

Accepted: 31 March 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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