What’s the diagnosis?
- Ruptured right posterior communicating artery aneurysm
- Other, more common causes of spontaneous subdural hematoma include trauma and coagulopathy
- Although uncommon, acute subdural hematoma due to aneurysmal rupture is a well known radiographic presentation, most commonly seen with ruptured posterior communicating artery aneurysms.
- Manual compression of the oculomotor nerve by posterior communicating artery aneurysms may → oculomotor nerve palsy (e.g, diplopia, ptosis, opthalmoplegia, pupillary dysfunction)
- In patients with ruptured PCOM aneurysms it appears that microsurgical clipping may afford a better chance of oculomotor nerve palsy improvement than endovascular coiling.