Acute subdural hematoma without subarachnoid hemorrhage or intraparenchymal hematoma caused by rupture of a posterior communicating artery aneurysm: case report and review of the literature.

Background: Acute subdural hematoma without subarachnoid hemorrhage or intraparenchymal hematoma is rare.

Methods: We report on a 47-year-old women without previous trauma who presented with an acute subdural hematoma without subarachnoid hemorrhage. The hematoma was evacuated immediately. Further evaluation with a cerebral four-vessel angiography revealed a left-sided posterior communicating artery aneurysm that was occluded by endovascular embolization. The patient recovered without neurological deficit.

Conclusions: Ruptured intracranial aneurysm should be considered as a cause of nontraumatic subdural hematoma. Immediate subdural hematoma removal after aneurysm coiling can be performed in such patients, even those in poor neurological condition.