RT Journal Article
T1 [Ruptured aneurysms presenting with subdural hematoma: management without angiography]
A1 Fernández Carballal, Carlos
A1 Muñoz, Eusebio
A1 Garcia Salazar, Francisco
A1 Cancela, Palomares
A1 Mateo Sierra, Olga
A1 Pinilla, David
A1 Mosqueira, Bernardo
AB Introduction: Ruptured aneurysms on rare occasions cause subdural hematomas as described in literature. Sudden deterioration and coma is a common feature in those patients and a emergent surgical attitude is prompt required, even without confirmation with angiography.Case reports: We described three cases with acute subdural hematomas and little or no subarachnoid hemorrhage caused by ruptured aneurisms who presented with rapid neurologic deterioration. Urgent craniotomy and evacuation of the hematoma was performed without previous angiography in the three patients. In two patients the aneurysm was found during surgical exploration and subsequently clipped; in the remaining patient the aneurysm was embolized postoperatively.Conclusions: The occurrence of a subdural hematoma caused by the rupture of an intracranial aneurysm must be suspected in spontaneous subdural hematomas, especially in association with disproportioned conscious deterioration. All the three patients we report debuted with sudden conscious deterioration. If a ruptured aneurysm causing subdural hematoma is suspected, early surgical intervention is required even if angiography is not available. Severe neurological deficit and uncal herniation might still be reversible if provided decompression can be carried out in promptly. Angiography availability should not postpone surgery. Aneurysm presence should be ruled out whether by surgical exploration or by delayed angiography. Posterior communicating aneurysm are related to formation of subdural hematoma.
PB IMR Press
SN 0210-0010
YR 2004
FD 2004
LK https://hdl.handle.net/20.500.14352/129339
UL https://hdl.handle.net/20.500.14352/129339
LA spa
NO Fernández-Carballal C, Muñoz-Fernández E, García-Salazar F, Cancela-Caro P, Mateo-Sierra O, Pinilla-Arias D, Mosqueira-Centurión B. Hematomas subdurales de causa aneurismática: estrategia terapéutica sin angiografía diagnóstica [Ruptured aneurysms presenting with subdural hematoma: management without angiography]. Rev Neurol. 2004 Aug 16-31;39(4):335-8. Spanish. PMID: 15340891.
DS Docta Complutense
RD 31 dic 2025