Ruptured intracranial aneurysms are often associated with subarachnoid or intraparenchymal hemorrhage. However, the prevalence of subdural hemorrhage post aneurysmal rupture is low and rarely reported in scientific studies. Here, we report an unusual case of a ruptured posterior communicating artery aneurysm resulting in an isolated subdural hematoma located in the tentorial and spinal canal without subarachnoid or intraparenchymal hemorrhage. In this case, a 34-year-old woman with no history of trauma or coagulopathy was diagnosed with a subdural hematoma in the tentorium cerebellum tracing to the subdural space of the spinal column. Computed tomography angiography was used to identify the source of the bleeding, which revealed a ruptured left-sided posterior communicating artery saccular aneurysm. The aneurysm was clipped, and the hematoma was evacuated. The patient recovered without any neurological complications. Our results suggest that a diagnosis of ruptured intracranial aneurysm should be considered in patients with nontraumatic subdural hematoma. Prompt diagnostic imaging and interventional diagnostic procedures are required to ensure proper management of these patients and to avoid unnecessary complications.

中文翻译：

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后交通动脉破裂破裂，表现为腱索和脊柱孤立性硬膜下出血：一例病例并文献复习。

颅内动脉瘤破裂通常与蛛网膜下腔或实质内出血有关。然而，动脉瘤破裂后硬膜下出血的发生率很低，科学研究中很少报道。在这里，我们报告了一种不寻常的情况，即后交通动脉瘤破裂，导致位于腱膜和脊髓中的孤立性硬膜下血肿，没有蛛网膜下腔或实质内出血。在这种情况下，一名无创伤或凝血病史的34岁妇女被诊断为小脑部硬膜下硬膜下血肿，并追踪到脊柱硬膜下腔。计算机断层扫描血管造影用于确定出血源，该出血源显示左侧后交通动脉囊状动脉瘤破裂。动脉瘤被剪断，血肿被疏散。患者康复，无任何神经系统并发症。我们的研究结果表明，非创伤性硬膜下血肿患者应考虑颅内动脉瘤破裂的诊断。需要及时的诊断成像和介入诊断程序，以确保对这些患者进行适当的治疗并避免不必要的并发症。