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Ruptured dermoid and subarachnoid hemorrhage

Case contributed by Andrew Lawson
Diagnosis certain

Presentation

Acute onset headache.

Patient Data

Age: 60 years
Gender: Female

There is acute subarachnoid hemorrhage, with a moderate amount of blood seen in the left sylvian cistern and left convexity, and small amount of blood in the third ventricle and occipital horns. There is mild hydrocephalus. Findings are suspicious for a left MCA trifurcation aneurysm. There is also a ruptured right parasellar dermoid cyst, that measures 3.2 cm in size.

An irregular/lobulated laterally-projecting left MCA M1 bifurcation aneurysm is confirmed.

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