Simultaneous Occurrence of Subarachnoid Hemorrhage Due to Ruptured Aneurysm and Remote Brainstem Hematoma

—Case Report—

Abstract

A 48-year-old woman presented with simultaneous aneurysmal subarachnoid hemorrhage (SAH) and remote intracerebral hemorrhage manifesting as sudden onset of severe headache, left hemiparesis, and diplopia. Emergent computed tomography revealed localized SAH in the interpeduncular cistern, and a remote brainstem hematoma in the right dorsolateral tegment. Neuroimaging found no signs of vascular anomaly in the brainstem. The aneurysm at the basilar artery and superior cerebellar artery bifurcation was successfully embolized using coils. Her postoperative neurological status was improved except for slight diplopia. The causes of this extremely rare case of simultaneous occurrence of aneurysmal SAH and remote brainstem hematoma in the dorsolateral tegment remain obscure.