Real-Time Imaging of Aneurysmal Rupture Causing an Isolated Acute Subdural Hematoma

A 51-year-old woman with hypertension presented with a 3-week history of progressive right cranial nerve III palsy and headache. During emergency department evaluation, while in the MRI scanner, she became acutely unresponsive. MRI captured a rapidly expanding acute subdural hematoma (aSDH) (Figure). She was taken for emergent decompressive craniectomy. Postoperative imaging demonstrated a ruptured right-sided posterior communicating artery aneurysm.

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