TY - JOUR
T1 - Acute subdural hematoma during sexual intercourse due to an aneurysm rupture on posterior communicating artery
T2 - a case report
AU - Bastiana, Dewi Setyaning
AU - Sani, Achmad Firdaus
AU - Ardhi, Mohammad Saiful
AU - Kurniawan, Dedy
AU - Suharto, Ade Pambayu
N1 - Publisher Copyright:
© 2023
PY - 2023/3
Y1 - 2023/3
N2 - Patients with an acute subdural hematoma (aSDH) usually have a history of head trauma, but some patients may present with spontaneous aSDH due to a ruptured aneurysm. Spontaneous aSDH is a rare manifestation of aneurysmal rupture. However, aneurysmal rupture remains a major cause of spontaneous aSDH. A 42-year-old man was brought to the emergency room because of a sudden loss of consciousness during sexual intercourse. The patient has seizures and weakness on the right side of his body. The patient has no history of trauma and has never taken anticoagulant or antiplatelet drugs, sexual aphrodisiacs, or other drugs. Physical examination revealed the Glasgow Coma Scale of E2V1M3, ptosis on the left eye, left pupil mydriasis, right central facial palsy, and right hemiparesis. Laboratory results showed hypercoagulopathy. Noncontrast head computed tomography scan revealed subdural hematoma with no subarachnoid or intraparenchymal hemorrhage. The patient underwent an emergency craniotomy, and the hematoma was evacuated. Cerebral angiography was performed 1 week later, revealing a saccular aneurysm in the left posterior communicating artery. The patient has successfully undergone endovascular coiling and was discharged from the hospital in good condition, fully conscious, with no weakness in half side of the body, but there is still third nerve palsy. Patients with pure aSDH without a history of trauma should consider the possibility of aneurysm rupture and perform an angiographic examination to rule out vascular malformations so that the patient can receive appropriate treatment.
AB - Patients with an acute subdural hematoma (aSDH) usually have a history of head trauma, but some patients may present with spontaneous aSDH due to a ruptured aneurysm. Spontaneous aSDH is a rare manifestation of aneurysmal rupture. However, aneurysmal rupture remains a major cause of spontaneous aSDH. A 42-year-old man was brought to the emergency room because of a sudden loss of consciousness during sexual intercourse. The patient has seizures and weakness on the right side of his body. The patient has no history of trauma and has never taken anticoagulant or antiplatelet drugs, sexual aphrodisiacs, or other drugs. Physical examination revealed the Glasgow Coma Scale of E2V1M3, ptosis on the left eye, left pupil mydriasis, right central facial palsy, and right hemiparesis. Laboratory results showed hypercoagulopathy. Noncontrast head computed tomography scan revealed subdural hematoma with no subarachnoid or intraparenchymal hemorrhage. The patient underwent an emergency craniotomy, and the hematoma was evacuated. Cerebral angiography was performed 1 week later, revealing a saccular aneurysm in the left posterior communicating artery. The patient has successfully undergone endovascular coiling and was discharged from the hospital in good condition, fully conscious, with no weakness in half side of the body, but there is still third nerve palsy. Patients with pure aSDH without a history of trauma should consider the possibility of aneurysm rupture and perform an angiographic examination to rule out vascular malformations so that the patient can receive appropriate treatment.
KW - Acute subdural hematoma
KW - Cerebral angiography
KW - Ruptured aneurysm
UR - http://www.scopus.com/inward/record.url?scp=85146452453&partnerID=8YFLogxK
U2 - 10.1016/j.radcr.2023.01.009
DO - 10.1016/j.radcr.2023.01.009
M3 - Article
AN - SCOPUS:85146452453
SN - 1930-0433
VL - 18
SP - 1316
EP - 1319
JO - Radiology Case Reports
JF - Radiology Case Reports
IS - 3
ER -