A case of aneurysmal subarachnoid hemorrhage in a young adult with hemiparesis

Abstract

We report a case of aneurysmal SAH in a young adult with hemiparesis. A-17-year-old woman was admitted to our hospital with sudden headache and right motor weakness. Head CT and 3D-CT-angiography revealed SAH due to ruptured saccular aneurysm of left internal carotid artery bifurcation. We performed surgical clipping and took measures to prevent cerebral vasospasm. The patient had a favorable outcome. Head MRI (7 days after the onset) showed infarction in the territory of left lenticulostriate artery with no angiographical spasm. Since the patient had no underlying disease that could cause cerebral infarction, we speculated that the pathology was due to subarachnoid hematoma, which caused physical damage to vulnerable perforating branch of the middle cerebral artery.