Abstract
A 73-year-old male presented with hypertensive intracerebral hemorrhage that mimicked middle cerebral artery aneurysm on CT angiography. Nonenhanced CT showed hemorrhage in the right basal ganglia with extension to the sylvian fissure. CT angiography (CTA) revealed an aneurysm-like enhancement adjacent to the right M3 branch to M4. The location of the lesion was atypical and the neck was obscure for a middle cerebral artery aneurysm. On CTA performed 1.5 hour after initial CTA, the aneurysm-like enhancement had vanished. The patient underwent hematoma evacuation by craniotomy. No aneurysm was found in an intraoperative view or on digital subtraction angiography performed after the operation.
We considered the aneurysm-like enhancement on CTA as contrast extravasation in the acute stage of hypertensive intracerebral hemorrhage.
