Pure Acute-on-Chronic Subdural Hematoma Due to Ruptured Posterior Communicating Artery Aneurysm: Unsuspecting Entity

Abstract

Background: Even though rarely reported as a cause of pure subdural hematoma (SDH), aneurysmal rupture should be suspected in patients with spontaneous SDH without coagulopathy.

Case description: We report a case of acute-on-chronic SDH in a 55-year-old lady with cerebral herniation due to a ruptured posterior communicating artery aneurysm. She was managed with single-stage SDH evacuation along with clipping of the aneurysm.

Conclusions: Computed tomography angiography of the head is advisable in patients with spontaneous SDH without coagulopathy. Pure SDH as compared with SDH associated with subacute hemorrhage, intraventricular hemorrhage, or intracerebral hemorrhage due to aneurysmal rupture has a good outcome.

Keywords: Intracranial aneurysm; Posterior communicating artery aneurysm; Subdural hematoma.