A 56-year-old woman was admitted after two episodes of severe headache accompanied by loss of consciousness. Examination revealed systemic hypertension, cardiac enlargement, and right-sided hemiparesis. Angiography detected bilateral middle cerebral artery aneurysms. Her condition rapidly worsened, and she died shortly after admission.
Pathology
The left cerebral hemisphere, sectioned parasagittally, shows a large cerebral haemorrhage involving the parietal and frontal lobes. The haemorrhage and associated clot have significantly distorted the external capsule and lateral ventricle. The bleeding originated from a ruptured aneurysm of the left middle cerebral artery.