Spontaneous resolution of ruptured dissecting anterior infer
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A 52-year-old woman presented with a history of sudden onset of a severe headache and vomiting with a negative history of loss of consciousness and seizure. On examination, she had neck stiffness with a blood pressure of 190/110 without any cranial nerve deficit. On computed tomography (CT) brain, there was a blood in perimesencehalic cisterns. CT angiography was normal, but digital subtraction angiography showed distal right AICA fusiform aneurysm involving the whole circumference of the vessel wall with late stagnation of contrast inside the aneurysm, suggestive of dissection etiology. She was offered the available modalities of treating dissecting AICA aneurysms, but she denied any intervention. Hence, patient was given the nimodipine - 60 mg 4 times a day, antihypertensives, antiepileptics and analgesics, patient was discharged after 12 days of conservative management with advice of complete bed rest and regular follow-up. Follow-up digital subtraction angiography (DSA) after 8 weeks, showed complete resolution of dissecting AICA aneurysm.

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