Accidental giant cerebral aneurysm in a case with recurrent primary intracerebral hemorrhage: Case report

Abstract

Intracerebral hematomas are % 10 of all strokes.Although there are many risc factors causing cerebral hematomas in young population, hypertension is still the major risc factor of all. The incidance of recurrent hemorrhagic stroke is % 2.4 per year in patients with intracerebral hematomas. There are no studies about the types of following hemorrhagic strokes and unruptured cerebral aneurisms are found in these patients. 44 years old hypertensive woman was admitted to our emergency department with speech disturbance. She had a history of left thalamic hematoma 6 mounths ago. In her neurological examination, she had dysarthria, vertical gaze disturbance and left hemihypoestesia. There was acute Grade 2B thalamic hematoma in her cranial tomography. She had uncontrolled renal hypertension for about 19 years. In her control tomographies there was a suspicious hypodensity in right cavernous sinuse, so cranial MRI and DSA were performed and an unruptured ICA aneurism was seen. In conclusion, hypertension is still the major risc factor for intracerebral hematomas in young population. Cerebral angiography is not routinely performed in primary intracerebral hematomas but in these patients not rarely unruptured aneurisms were found. Especially in literature, they were seen in young females.By our presentation we aimed to remember that although there are huge unruptured aneurisms are present, hypertension is still the major risc factor of intracerebral hematomas and vascular malformations can also exist in primary cerebral hematomas especially in young female patients.