Presentation
Hypertension. Recently confusion.
Patient Data
In non-contrast axial images: there is subarachnoid hemorrhage evident by curvilinear hyperdensities in the basal cisterns and sulci as well as in the falx cerebri and tentorium cerebelli. There is also hemorrhage in the 4th ventricle likely to be causing mild dilatation of third and lateral ventricles (Triventricular hydrocephalus).
In contrast-enhanced axial images of arterial phase: there is evidence of saccular aneurysm in the supraclinoid region of internal carotid artery just before it bifurcates into MCA and ACA.
The VR 3D images also demonstrate the aneurysm clearly.
Case Discussion
The imaging findings described above are consistent with supraclinoid aneurysm with subarachnoid hemorrhage and intraventricular hemorrhage (4th ventricle) resulting in the mild triventricular hydrocephalus.
This case is also contributed by Dr. Mohammad Tahir Aien.
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