Ruptured Dissecting Aneurysm of the Distal Middle Cerebral Artery: Case Report

We present a rare case of a dissecting ruptured aneurysm of the right distal middle cerebral artery associated with subcortical hematoma and subarachnoid hemorrhage. A 57-year-old man with sudden onset of severe headache and left hemiplegia was referred to our hospital. A CT scan showed a subarachnoid hemorrhage in the right sylvian fissure associated with subcortical hematoma in the right temporo-parietal lobe. The right carotid angiogram revealed a fusiform aneurysm in the distal middle cerebral artery. The aneurysm was successfully excised. The postoperative course was uneventful, and his left hemiparesis recovered well. The distal middle cerebral dissecting aneurysm is extremely rare. We present this case with a review of the literature.