PubMed1978
Extravasation of contrast media through ruptured intracranial aneurysm has been reported as an unusual case. Among the reported cases, a ventricular opacification is very rare, and in such cases, the prognosis is worst. In this paper, two cases with an aneurysm bleeding into the ventricular system were reported. Case 1. A 37-year-old woman was admitted because of severe headache and disturbance of consciousness. On admission, she was deeply comatose with decerebrate rigidity. Carotid angiogram taken 2 hours and 30 minutes after the attack revealed an aneurysm of the anterior communicating artery and an extravasation of contrast media into the lateral ventricle. Although a continuous ventricular drainage was instituted immediately, the patient died after five days. Case 2. A 33-year-old man suddenly developed severe headache with subsequent loss of consciousness. Two hours after the onset, the patient was admitted in comatose state. Angiography taken 3 hours after the attack demonstrated an aneurysm of the anterior communicating artery. The posterior horns of the lateral ventricles were opacificated. The patient died after 24 hours. In case 1, it was interesting that a remarkable stenosis of the cisternal portion of the internal carotid artery was demonstrated at the 2nd carotid angiography (lateral view), but the third carotid angiography taken after the continuous ventricular drainage showed a complete recovery from the stenosis. This stenosis was supposed to be caused by a compression of the internal carotid artery against the interclinoid ligamentum. Moreover, a rapid enlargement of the aneurysm was noticed by repeated angiography.