Acute subdural hematoma without subarachnoid hemorrhage secondary to rupture of the middle cerebral artery. Case report and literature reviewcondary to rupture of the middle cerebral artery. Case report and literature review
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Abstract
A 60-year-old man came to the emergency room with sudden onset symptoms, characterized by intense headache lasting one day, with a score of 10/10 on the analog pain scale, located predominantly in the right fronto-parietal region. During the episode, the patient experienced transient loss of consciousness for 15 minutes. After regaining consciousness, paresthesia of the right upper limb was evident. Upon admission, vital signs were within normal parameters, but he was disoriented and had weakness in his right hand. A CT scan of the skull revealed a left frontotemporal subdural hematoma with a slight mass effect on adjacent intracranial structures, and CT angiography revealed the presence of an aneurysm in the left middle cerebral artery. After evaluating the case, they determined that the patient was at high risk of neurological deterioration, rebleeding, and secondary intraparenchymal hemorrhage. Consequently, they performed an emergency craniotomy to evacúate the hematoma in the left cerebral hemisphere and microsurgical clipping of the aneurysm. His progress in the ward was favorable, allowing him to be discharged. During outpatient follow-up, the patient showed complete neurological recovery.
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Hematoma subdural acute, middle cerebral artery, aneurysm ruptured, Intracranial aneurysm
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