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Washington University Experience | VASCULAR | Aneurysm - Saccular | 9A5 Aneurysm ACA-ACommunicating & SAH (Case 9) 7
The midbrain shows anterior-posterior elongation and lateral compression consistent with uncal herniation but lacks Duret hemorrhages. ---- Case 9 Denouement: This pattern of hemorrhage is consistent with rupture of an artery or aneurysm in the vicinity of the anterior communicating artery, a common site of saccular aneurysm; blood at high pressure floods the basal cisterns and subarachnoid space and dissects into the adjacent soft brain parenchyma. No definitive evidence of an aneurysm was found, but coincident rupture and obliteration of such a structure is not uncommon and cannot be excluded with certainty.
