Early death from rupture of an intracranial aneurysm

✓ The authors studied the clinical features and computerized tomography scans of 31 patients who died within 24 hours after the rupture of an intracranial aneurysm. Nine patients showed evidence of an intracerebral hematoma and brain shift, eight of a massive intraventricular hemorrhage, eight of both a hematoma and ventricular hemorrhage, and six of only subarachnoid hemorrhage (SAH). These anatomical types of hemorrhage could not be distinguished clinically. Four of the six patients with only SAH suffered initial apnea and circulatory arrest. In these cases, secondary brain damage may have been caused by anoxia, and therefore might have been reversible.