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VOLUME 1 , ISSUE 2 ( May-August, 2023 ) > List of Articles

CASE REPORT

A Rare Case of Anterior Communicating Artery Aneurysm Rupture Presenting as Perimesencephalic Subarachnoid Haemorrhage

Renaldo Pavrey, Vikrant Chouhan, Aakanksha Goyal

Keywords : ACom aneurysm, Case report, Perimesencephalic, Subarachnoid haemorrhage

Citation Information : Pavrey R, Chouhan V, Goyal A. A Rare Case of Anterior Communicating Artery Aneurysm Rupture Presenting as Perimesencephalic Subarachnoid Haemorrhage. 2023; 1 (2):52-55.

DOI: 10.5005/njem-11015-0012

License: CC BY-NC 4.0

Published Online: 05-12-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Perimesencephalic subarachnoid haemorrhage (PMSAH) is a distinct pattern of non-aneurysmal subarachnoid haemorrhage (SAH) centred on the basal cisterns around the midbrain. It is rare, with an incidence of 0.5 in 1,00,000 adults. Also, PMSAH represents 5–10% of all SAHs and nearly 33% of all non-aneurysmal SAH. While 95% of PMSAH are non-aneurysmal, 5% of cases are due to a vertebrobasilar aneurysm. We present the case of a 59-year-old female with PMSAH in whom the source of the bleeding was localised to a ruptured anterior communicating artery (ACom) aneurysm. In our report, we highlight the characteristic neuroimaging findings of PMSAH, the importance of digital subtraction angiography (DSA), and the necessity for an interdisciplinary approach in the management of such cases. Our reason for highlighting this case is that PMSAH is a rare cause of non-traumatic, predominantly non-aneurysmal SAH. In the setting of a ruptured ACom artery aneurysm, we believe the uniqueness of this case gets elevated.


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