Two cases of ruptured distal anterior cerebral artery aneurysms presenting as a pure acute subdural hematoma with a good outcome

Abstract

Nontraumatic acute subdural hematomas can arise from various causes. Clinical diagnosis of a ruptured cerebral aneurysm is important because it influences the treatment. When a patient presents with coma at onset or without subarachnoid or intracerebral hemorrhage, traumatic acute subdural hematomas may be diagnosed and treated initially. Ruptured aneurysms may be overlooked, and re-rupture would result in a poor prognosis.

Here, we report two cases of ruptured distal anterior cerebral artery aneurysms that presented as nontraumatic acute subdural hematomas. Clinical diagnosis was difficult to obtain based on history and imaging findings. Nevertheless, after definitive diagnosis, the endovascular treatment was performed, and the prognosis was excellent.