Multiple aneurysms Rt ICA,left ICA and left M1 segment of MCA
New Case 50 yr,F ,presented with abrupt onset of severe head ache without vomiting or vertigo developed on 4th of this month. She was evaluated and admitted at local hospital, CT brain was done and then transferred to our hospital for further management after 2 days. Known hypertensive pn regular med. On exam ,vitals stable BP 160/ 90mmhg.fully concious,communicating well .No focal deficits. No neck stiffness. Diagnosis and management?
Thanks Curofy and others who answered the case. CT with CTA: * Thin SAH in bilateral frontoparietal cortical sulci,interhemispheric fissure,and bilateral sylvian fissures. * Wide necked Saccular aneurysm arising from the Rt Supraclinoid ICA,with a test directed anteriorly. * Saccular aneurysm arising the left supraclinoid ICA and another from proximal M1 segment of Left MCA. Neurosurgeon discussed the management with the relatives regarding the coiling of Rt ICAaneurysm and flow diversion of left ICA aneurysm.Relatives opted for surgery at Govt MCH due to financial constraints
Thanks Curofy and others who answered the case. CT with CTA: * Thin SAH in bilateral frontoparietal cortical sulci,interhemispheric fissure,and bilateral sylvian fissures. * Wide necked Saccular aneurysm arising from the Rt Supraclinoid ICA,with a test directed anteriorly. * Saccular aneurysm arising the left supraclinoid ICA and another from proximal M1 segment of Left MCA. Neurosurgeon discussed the management with the relatives regarding the coiling of Rt ICAaneurysm and flow diversion of left ICA aneurysm.Relatives opted for surgery at Govt MCH due to financial constraints
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Acute SAH . Multiple aneurysm in bilateral ACA With suggested rupture of rt sided aneurysm
SAH Probably r ACom, in vessel imaging there is possibility of aneurysm on left side also
Sah minimalwith paraclinoidanurysms one of it bled. coiling may be attempted
Haemorrhage in right side. Aneurysm bleed -of right anterior communicating artery
Cerebral anurysm. Haemorrhage in rt side.
Cerebellar haemorrhage
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