We describe a 31-year-old woman who presented with acute right-sided weakness and was found to have a subarachnoid hemorrhage in the left Sylvian fissure and an ipsilateral frontal intraparenchymal hemorrhage. CT angiography revealed an occlusion of the left middle cerebral artery's M1 segment and a saccular aneurysm at its bifurcation. A cerebral angiogram confirmed these findings, and the patient subsequently underwent microsurgical aneurysm resection, which revealed a partially thrombosed pseudoaneurysm. Further stroke workup identified mitral valve vegetation, confirming the diagnosis of infective endocarditis.
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Singh et al. (2024) studied this question.
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