Spontaneous acute subdural haemorrhage with rupture of distal anterior cerebral artery aneurysm: A case report and review of literature

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Pure subdural hematoma with subarachnoid haemorrhage brought about by ruptured intracranial aneurysm is uncommon and is related to delayed analysis and treatment. We present an uncommon instance of spontaneous subdural hematoma because of intracranial aneurysmal rupture. A 26-year-old female presented with sudden onset of thunderclap headache at midnight followed by an episode of generalized tonic-clonic seizure and loss of consciousness. There was no associated history of trauma. Computed tomography showed convexity subdural hematoma extending into tentorium without subarachnoid haemorrhage. The catheter angiography revealed a distal anterior cerebral artery aneurysm at the anterior internal frontal artery. Consequently, this aneurysm was embolized with squid with no residual filling. The patient was neurologically intact and was discharged on the third post-procedure day with left partial third nerve palsy. This paper demonstrates characteristics, diagnostics, and treatment modalities of this rare condition of intracranial aneurysmal rupture associated with subdural hematoma along with the literature review.

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