Abstract
We report the case of a ruptured basilar artery (BA)‒left superior cerebellar artery (SCA) bifurcation aneurysm treated by coil embolization and two endoscopic surgery techniques. A 67‒year‒old Japanese woman was admitted to our hospital for the evaluation of a headache followed by coma. Computed tomography (CT) revealed a subarachnoid hemorrhage (SAH) accompanied by an intraventricular hematoma (IVH) and an intracerebral hematoma (ICH). CT angiography showed a ruptured BA‒left SCA aneurysm. After performing coil embolization for the ruptured aneurysm, we conducted an endoscopic evacuation of the intracranial hematomas. The IVH was evacuated with the use of a flexible endoscope, and the ICH was evacuated with a rigid endoscope. Although the surgical procedure was completed without complications, the patient showed persistent consciousness disturbance. In our opinion, a combination of coil embolization and endoscopic surgery is less invasive than a craniotomy, and when performing endoscopic surgery for intracranial hematomas associated with SAH, surgeons should consider the safety of the procedure based on the hematoma distribution.
