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Washington University Experience | VASCULAR | Aneurysm - Saccular | 15A0 Case 15 History
Case 15 History ---- The patient was a 49-year-old woman who was found unresponsive while taking a shower. While in the ED, she was unresponsive with hyperventilation and was subsequently intubated. Work up revealed a right internal carotid artery aneurysm with a subarachnoid hemorrhage and a left subdural hematoma with 5 mm subfalcine herniation. Cerebral angiogram revealed a right internal carotid artery aneurysm. Interventional radiology coiled the aneurysm and achieved greater than 95% obliteration. She was then observed and treated in the Intensive Care Unit over the next 12 days for cerebral edema and mild vasospasm. A repeat angiogram on May 28, 2013 demonstrated mild vasospasm that was treated. Her external ventricular drain was weaned and she transferred to a step down unit. She had impaired memory and attention, along with a dependency for activities of daily living (ADL). After spending 12 days in the hospital, she was discharged to The Rehab Institute. Two days later on June 8, 2013, while in rehab, she developed a new onset seizure and was immediately taken back to the ED. Upon arrival she was poorly responsive and noted to be shaking. She was also short of breath, with tachypnea and sinus tachycardia. Shortly after arrival she coded and was pronounced dead
