Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Acute Aneurysmal Subdural Hematoma: Clinical and Radiological Characteristics

  • Park, Sung-Man (Department of Neurosurgery, Our Lady of Mercy Hospital, College of Medicine, The Catholic University of Korea) ;
  • Han, Young-Min (Department of Neurosurgery, Our Lady of Mercy Hospital, College of Medicine, The Catholic University of Korea) ;
  • Park, Young-Sup (Department of Neurosurgery, Our Lady of Mercy Hospital, College of Medicine, The Catholic University of Korea) ;
  • Park, Ik-Sung (Department of Neurosurgery, Holy Family Hospital, College of Medicine, The Catholic University of Korea) ;
  • Baik, Min-Woo (Department of Neurosurgery, Holy Family Hospital, College of Medicine, The Catholic University of Korea) ;
  • Yang, Ji-Ho (Department of Neurosurgery, Daejon St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • Published : 2005.05.28
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Abstract

Objective: Acute spontaneous subdural hematoma(SDH) secondary to a ruptured intracranial aneurysm is a rare event. The authors present nine cases with aneurysmal SDH. Methods: We analyzed nine cases of aneurysmal SDH from 337 patients who underwent treatment for a ruptured aneurysm between January 1998 and May 2004. Clinical and radiological characteristics and postoperative course were evaluated by reviewing medical records, surgical charts and intraoperative videos. Results: The nine patients comprised four males and five females with a mean age of 53years (range 15-67years). The World Federation of Neurosurgical Societies grades on admission were I in one patient, II in two patients, III in five patients and V in one patient. With respect to location, there were four internal carotid-posterior communicating artery(ICA-Pcom) aneurysms, one distal anterior cerebral artery(DACA) aneurysm, one anterior communicating artery and three middle cerebral artery aneurysms. CT scans obtained from the four patients with ICA-Pcom aneurysms revealed SDH over the convexity and along the tentorium, and two of these patients presented with pure SDH without subarachnoid hemorrhage(SAH). In three patients with ICA-Pcom aneurysm, the ruptured aneurysm domes adhered to the petroclinoid fold. In the patient with the DACA aneurysm, the domes adhered tightiy to the pia mater and the falx. Conclusion: Ruptured intracranial aneurysm may cause SDH with or without SAH. In the absence of trauma, the possibility of aneurysmal SDH should be considered.

Keywords

References

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