Status post ruptured aneurysm coiling, with altered mental status change

Tuesday, 22 Jul 2008 00:05:20 GMT

A 70-year-old female patient was admitted to the emergency room with a suspected subarachnoidal hemorrhage (SAH). Initial non-enhanced cranial CT (NECT) noted a small subarachnoidal bleeding in the sylvian fissure on the right side. On intracranial C T-angiography (CTA) a giant-aneurysm (17 x 11 mm) of the right middle cerebral artery (MCA) was detected.

The patient was transferred to the neurosurgery department for aneurysm clipping therapy. Due to massive calcifications at the neck of the aneurysm, no appropriate position of the aneurysm clip could be achieved. Two days later the patient underwent endovascular coil embolization of the MCA aneurysm.

On the sixth day after SAH, duplex sonography revealed high flow rates of the intracranial arteries and the patient was referred to the radiology department for comprehensive stroke imaging, including NECT and Volume-Perfusion-CT (VPCT) of the brain to rule out vasospasm.

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Status post ruptured aneurysm coiling, with altered mental status change