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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 25:1006-1007, June-July 2004
© 2004 American Society of Neuroradiology

Case Report
BRAIN

Bilateral Tentorial Subdural Hematoma without Subarachnoid Hemorrhage Secondary to Anterior Communicating Artery Aneurysm Rupture: A Case Report and Review of the Literature

Ajit A. Krishnaney^a, Peter A. Rasmussen^a and Thomas Masaryk^a,b

^a Section of Endovascular Neurosurgery, Department of Neurosurgery, Cleveland Clinic, Cleveland, OH
^b Department of Neuroradiology, Cleveland Clinic, Cleveland, OH

Address correspondence to Ajit A. Krishnaney, MD, Department of Neurosurgery, Cleveland Clinic, S-80, 9500 Euclid Avenue, Cleveland, OH 44195

Summary: A case of acute subdural hematoma over the tentorium secondary to rupture of an anterior communicating artery aneurysm is reported. A 42-year-old female patient presented with acute-onset, severe bifrontal and retro-orbital headache. CT revealed only symmetric thickening of the tentorium. MR imaging revealed the presence of a 10-mm anterior communicating artery aneurysm, which was confirmed by digital subtraction angiography. The radiologic findings and possible mechanisms of this hemorrhage are discussed.