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AJNR - American Journal of Neuroradiology

Published ahead of print on October 5, 2007
doi: 10.3174/ajnr.A0726

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American Journal of Neuroradiology 28:2014-2016, November-December 2007
© 2007 American Society of Neuroradiology

Case Report
BRAIN

Migrating Subdural Hematoma without Subarachnoid Hemorrhage in the Case of a Patient with a Ruptured Aneurysm in the Intrasellar Anterior Communicating Artery

R. Gilad^a, G.M. Fatterpekar^b, D.M. Johnson^c and A.B. Patel^c

^a Departments of Neurosurgery, Mount Sinai School of Medicine, New York, New York
^b Departments of Radiology, Mount Sinai School of Medicine, New York, New York
^c Departments of Neurosurgery and Radiology, Mount Sinai School of Medicine, New York, New York

Please address correspondence to Ronit Gilad, MD, Department of Neurosurgery, Mount Sinai School of Medicine, One Gustave Levy Place, New York, NY 10029; e-mail: ronit.gilad{at}mssm.edu

SUMMARY: Acute spontaneous subdural hematoma without the presence of a subarachnoid hemorrhage as a result of a ruptured aneurysm is rare. We present the case of a patient with an aneurysm of the intrasellar anterior communicating artery that caused hemorrhage solely into the subdural space. The hemorrhage then migrated down the spinal canal. Our case is unique because all these 3 rare processes occurred in a single patient. Identification of the cause of this type of hemorrhage in a timely fashion is crucial to the management of such a patient.