A 38-year-old woman presented with a sudden and severe headache in the left side of the head  associated with  Loss of consciousness during her job.On examination she was found to have left sided dialated pupil and at the time of examination her GCS was 15/15.An emergency CT was done.
The Left sided carotid artery angiography of her is given here.
Identify what is the abnormality and the anotomical location of that abnormality?
What would be the reason for her Clinical Picture?



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20 comments

  1. Anonymous Says:
  2. Aneurysm

     
  3. Anonymous Says:
  4. ruptured aneurysm

     
  5. Anonymous Says:
  6. trombosis

     
  7. Anonymous Says:
  8. i suspect thrombosis

     
  9. Anonymous Says:
  10. carotid aneurysm in the left internal carotid artery.it results due to weakening or stretching of vessel wall,it can occur after trauma, infection or previous surgery of carotid artery.

     
  11. Anonymous Says:
  12. Aneurysm

     
  13. Anonymous Says:
  14. arash from iran
    aneurysm in posterior cerebral artery or posterior communicating artery (latter is branch of MCA)

    anisocoria due to compression of third nerve

     
  15. Anonymous Says:
  16. arash form iran

    aneurysm in posterior cerebral artery or posterior communicating artery (latter is branch of MCA)

    anisocoria due to compression of third nerve

    i think her aneurysm is not ruptured because there is no any contrast leakage

    i think she had just pulsatile aneurysm not SAH , because her headache is left sided , in SAH patient has GENERALIZED headache not left or right sided headache second reason she has no SAH is lack of contrast leakage in angiography

    for definite diagnosis of SAH we need her CT scan and if it is normal lumbar puncture should be done

     
  17. Anonymous Says:
  18. what is diagnosis?

     
  19. Anonymous Says:
  20. thrombosis and many emvolisms

     
  21. Anonymous Says:
  22. what is true diagnosis? you should tell us true diagnosis before starting new case

     
  23. Anonymous Says:
  24. without telling us true diagnosis , your site is not teaching

     
  25. Correct answer_ SAH due do rupture of the aneurysm in posterior communicating artery.Anisocoria is resulted from the dirrect compression of the 3rd Nerve by the aneurysm...

     
  26. Bobbymurjani Says:
  27. the diagnose is aneurysm of artery on the side of N III compression that lead to impaired the function..

     
  28. Anonymous Says:
  29. Dr. Alhyari from Jordan ...

    I guess the presentation fits either an aneurysm or Internal Carotid artery dissection ! Not sure how the latter looks like on angiography though !

     
  30. Anonymous Says:
  31. Ruptured aneurysm of left Pcom a.

     
  32. Anonymous Says:
  33. why dont you tell us true diagnosis and initiate next case

    which of the above names in comments is webmaster?

     
  34. sharimi Says:
  35. arash from iran,you are blessed.....ever so detailed and straight to the point,you ll never know how much you have blessed me by sharing your knowledge...are u a GP?

     
  36. Anonymous Says:
  37. arash!! have u evr been to karachi pakistan?
    hav u ever entered DOW MEDICAL COLLEGE?
    r u the same one?

     
  38. Anonymous Says:
  39. intracrainial aneurysm caused by increase high blood pressure and leading to thrombosis of the artries and veins

     

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