GDC Embolization of Intracranial Aneurysms with SAH and Mass Effect by Subdural Haematoma. A Case Report and Review.

A 43-year-old woman was brought to the emergency room due to the sudden onset of severe headache and stuporous consciousness. She had no history of head injury. Computerized tomography scan revealed subarachnoid haemorrhage and left SDH with midline shift of about 10 mm. Cerebral angiography demonstrated anterior communicating artery and right middle cerebral artery bifurcation aneurysms. Her family refused operation due to her religion never to permit blood transfusion. So just aneurysm coiling and medical ICP control was planned. Guglielmi detachable coil (GDCs) embolization of the two aneurysms was successfully performed. She made a neurological recovery after embolization without evacuation of the SDH. She was discharged from hospital with no neurological deficit on day 21. We report our experience of successful GDC embolization on multiple aneurysms without craniotomy even in the selected case of mass effect.