CASE HISTORY/CLINIC:
A 55-year- old patient suddenly complains of severe headache during sexual intercourse. Patient is comatose



FINDINGS:
Noncontrast CCT: hyperdense (60-80 HE), enlarged appearance of the subarachnoid space. Hyperdense (60-80 HE) structures in the sulci. Swelling with flattened gyri and sulci. Roundish hyperdensity in the sylvian fissure.


DIAGNOSIS:
Acute subarachnoid hemorrhage with evidence of blood in the basal cisterns and in the sylvian fissure on both sides.
Brain edema.
Rupture of an aneurysm of the left middle cerebral artery in the sylvian fissure.

web resources:

1) AWMF
2) MRI-Library