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Year : 2015  |  Volume : 35  |  Issue : 4  |  Page : 179-181

The distribution of subarachnoid and intraventricular hemorrhage on computed tomography suggests the location of an idiosyncratic vascular lesion

1 Department of Surgery, Division of Neurosurgery, Far Eastern Memorial Hospital, New Taipei, Taiwan
2 Department of Surgery, Division of Neurosurgery, Hospital and College of Medicine, National Taiwan University; Taipei, Taiwan

Correspondence Address:
Chung Liang Chai
Department of Surgery, Far Eastern Memorial Hospital, 21 Nan-Ya South Road, Section 2, Banqiao, New Taipei 22060
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1011-4564.163829

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The incidence of aneurysmal subarachnoid hemorrhage (SAH) associated with intraventricular hemorrhage (IVH) varies. In general, the anterior communicating artery and posterior circulation aneurysms cause such IVHs. A 48-year-old man visited the Neurosurgical Department for the evaluation of a severe thunderclap headache that had awakened him from sleep. Brain computed tomography revealed diffuse, but asymmetric, SAH. Digital subtraction cerebral angiography (DSA) showed multiple vascular lesions, including an obvious saccular aneurysm on the left anterior choroidal artery. After surgical clipping, rebleeding was noted, and repeat DSA demonstrated that the bleeding site was on the right posterior cerebral artery. The distribution of SAH associated with the preserved Liliequist membrane may suggest the origin of the bleeding. Treatment of the correct bleeding site is effective for preventing rebleeding.

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