Ruptured Intracranial Aneurysm Presenting as a Significant Intracerebral Hematoma without Visible Subarachnoid Hemorrhage on Computed Tomography: a case report

Abstract

Although intracerebral hemorrhage (lCH) secondary to intracranial aneurysm rupture has been documented to occur in approximately 4% to 42.6% of patients, ICH without subarachnoid hemorrhage (SAH) is rare. The condition is mainly associated with rupture of a middle cerebral artery aneurysm. We report the case of a 57-year-old woman with significant intracerebral hematoma without visible SAH on computed tomography (CT). CT angiography (CTA) of the brain subsequently revealed an aneurysm arising from the supraclinoid portion of the left internal carotid artery near the origin of the left posterior communicating artery, which was considered to result in ICH. Aneurysm rupture should be included in the list of differential diagnoses when ICH is encountered at an atypical site of hypertensive hemorrhage, even in patients without SAH.