Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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January 9, 2012
Subdural Hematoma from a Ruptured Pericallosal Artery Aneurysm
- Subdural hematomas (SDH) secondary to rupture of intracranial aneurysms without the presence of subarachnoid hemorrhage (SAH) are rare.
- There are two possible mechanisms for the development of SDH associated with aneurysm. One theory suggests that the force of the rupture results in a break in the arachnoid with subsequent effusion of blood into the subdural space. The second proposes that one or more minor hemorrhages result in the formation of adhesions between the aneurysm and the arachnoid, creating a path for blood to enter the subdural space with subsequent rupture.
- DDx: Subdural hematomas secondary to trauma or coagulopathy.
- Rx: Endovascular (coiling) or surgery (clipping).
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