PA,Masaryk T. Bilateral tentorial subdural hematomawithout subarachnoid hemorrhage secondary to anterior communicating artery aneurysm rupture: a case report and review of the literature

Summary: A case of acute subdural hematoma over the tentorium secondary to rupture of an anterior communi-cating artery aneurysm is reported. A 42-year-old female patient presented with acute-onset, severe bifrontal and retro-orbital headache. CT revealed only symmetric thick-ening of the tentorium. MR imaging revealed the presence of a 10-mm anterior communicating artery aneurysm, which was confirmed by digital subtraction angiography. The radiologic findings and possible mechanisms of this hemorrhage are discussed. Approximately 3 % of ruptures of intracranial an-eurysms result in subdural hematomas. Seventy per-cent of these aneurysms arise from either the internal carotid artery or the middle cerebral artery. Subdural hematoma from intracranial aneurysm rupture with