Nguyen Ha Son, Doan Ninh, Shabani Saman, Gelsomino Michael, Zaidat Osama
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Department of Neurology, St. Vincent Mercy Hospital, Toledo, Ohio, USA.
Surg Neurol Int. 2016 Aug 1;7(Suppl 18):S499-501. doi: 10.4103/2152-7806.187490. eCollection 2016.
Pure subdural hematoma (without subarachnoid, intraventricular, or intraparenchymal hemorrhage) due to a ruptured intracranial aneurysm is rare. Most reported cases involve an aneurysm along the internal carotid artery, posterior communicating artery, or middle cerebral artery. No reports have described an aneurysm along the transmastoid branches of the occipital artery.
A 70-year-old female presented with sudden-onset, excruciating headaches, associated with dizziness, nausea, and emesis. There was no history of trauma. Computed tomography (CT) head demonstrated a pure tentorial subdural hematoma. Vascular imaging revealed bilateral aneurysms along the transmastoid branches of the intracranial portion of both the occipital arteries. Consequently, these branches were embolized, with no residual filling of the aneurysms. After the procedure, the patient remained neurologically well. The patient was monitored appropriately for vasospasm, and was discharged home 10 days after presentation.
Rupture of aneurysms along intracranial branches of the occipital artery can lead to pure subdural hematoma along the tentorium.
颅内动脉瘤破裂导致的单纯硬膜下血肿（无蛛网膜下腔、脑室内或脑实质内出血）较为罕见。大多数报道的病例涉及颈内动脉、后交通动脉或大脑中动脉的动脉瘤。尚无关于枕动脉经乳突分支处动脉瘤的报道。
一名70岁女性突发剧烈头痛，伴有头晕、恶心和呕吐。无外伤史。头颅计算机断层扫描（CT）显示为单纯小脑幕硬膜下血肿。血管成像显示双侧枕动脉颅内段经乳突分支处有动脉瘤。因此，对这些分支进行了栓塞，动脉瘤无残余充盈。术后，患者神经功能良好。对患者进行了适当的血管痉挛监测，就诊10天后出院。
枕动脉颅内分支处的动脉瘤破裂可导致小脑幕单纯硬膜下血肿。
