Ruptured middle cerebral artery aneurysm presenting as subdural haematoma

O. Rooney, Ramesh Kumar Athi Kumar, P. M. Thomas, D. Rawluk

Research output: Contribution to journalArticle

Abstract

In summary, this case demonstrated aneurysmal rupture as an unusual cause of a subdural haematoma. Although increasingly reported in the literature many factors about these cases remain uncertain. The aetiology of such haemorrhages is as yet unclear and unproven and the definitive management of these cases remains a cause for deliberation. It is widely accepted that in neurologically stable patients, even those with large intracerebral haematomas, acute aneurysmal surgery without definitive angiographic verification is not recommended. However, in cases similar to ours in which the patient is neurologically compromised the management is less clear cut. Should rapid decompressive surgery be carried out, delaying angiographic demonstration of the aneurysm and definitive surgical management until the patient is neurologically stable? Should these patients be managed with performance of a preoperative angiogram, followed by craniotomy, evacuation of the haematoma and clipping of the responsible aneurysm? Or should emergency surgery with evacuation of the haematoma and exploration for a possible aneurysm be performed without awaiting angiographic guidance? Each method has apparent advantages and clear disadvantages. It would appear that all three options are acceptable and the approach should be dictated by the clinical conditions of such patients.

Original languageEnglish
Pages (from-to)47-50
Number of pages4
JournalIrish Medical Journal
Volume96
Issue number2
Publication statusPublished - Feb 2003
Externally publishedYes

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Subdural Hematoma
Intracranial Aneurysm
Hematoma
Aneurysm
Craniotomy
Case Management
Rupture
Angiography
Emergencies
Hemorrhage

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ruptured middle cerebral artery aneurysm presenting as subdural haematoma. / Rooney, O.; Athi Kumar, Ramesh Kumar; Thomas, P. M.; Rawluk, D.

In: Irish Medical Journal, Vol. 96, No. 2, 02.2003, p. 47-50.

Research output: Contribution to journalArticle

Rooney, O. ; Athi Kumar, Ramesh Kumar ; Thomas, P. M. ; Rawluk, D. / Ruptured middle cerebral artery aneurysm presenting as subdural haematoma. In: Irish Medical Journal. 2003 ; Vol. 96, No. 2. pp. 47-50.
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