A 40-year-old female, with acromegalic features, presented with sudden-onset headache and vision loss followed by altered sensorium of three-day duration. Her acral enlargement and prognathism existed for the past five years. On neurological examination, her Glasgow Coma Scale score was ElVtM4 and she required intubation to secure the airway. Computed tomography (CT) of head showed pure anterior third ventricular bleed with obstructive hydrocephalus [Figure 1]. With a provisional diagnosis of anterior communicating artery (ACoM) aneurysmal rupture, CT-angiography (CTA) was performed. As CTA [Figure 2] did not reveal any aneurysm, contrast-enhanced magnetic resonance imaging (MRI) was performed [Figures 3 and 4].
展开▼
