Hematoma of cavum septum pellucidum by ruptured aneurysm

A 57-year-old male patient, with no past medical history, was admitted with sudden-onset headaches, vomiting, and loss of consciousness. A neurological examination revealed disorientation. His pupils were equal and reactive to light. He had purposeful responses of all extremities. The blood pressure was 200/100 mmHg. Complete blood counts and coagulation profiles were normal. Unenhanced cerebral computed tomography (CT) showed corpus callosum hematoma, septum pellucidum hematoma, and intraventricular flooding corresponding to Fisher grade 4 subarachnoid hemorrhage. Cerebral angiography showed an anterior communicating artery aneurysm, suggesting the diagnosis of subarachnoid hematoma (SAH) due to a rupture of an anterior communicating artery aneurysm. An external ventricular shunt was placed. Afterward, the patient was treated by endovascular embolization the next day.