Deadly headache: Mirror aneurysm about a case report

• Autores: Dávila hernández, Carlos Alberto, Arriola Torres, Luis Fernando, Moreno Legua, Jorge Eduardo, Carrasco Farfan, Carlos Andres, Camara Reyes, Ramon Rolando
• Formato: artículo
• Fecha de Publicación: 2022
• Institución: Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo
• Repositorio: Revista del Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo
• Lenguaje: español
• OAI Identifier: oai:cmhnaaa_ojs_cmhnaaa.cmhnaaa.org.pe:article/1375
• Enlace del recurso: https://cmhnaaa.org.pe/ojs/index.php/rcmhnaaa/article/view/1375
• Nivel de acceso: acceso abierto
• Materia: cefalea; aneurisma; angiografía por tomografía computarizada; Aneurisma Intracraneal; Neurocirugia; Informes de Casos; headache; aneurysm; computed tomography angiography; Intracranial Aneurysm; Neurosurgery; Case Reports

Introduction: Intracerebral aneurysms are incidental findings in imaging studies performed for other diagnoses. Case Report: 35-year-old female patient, who presented syncope after severe headache without yielding to conventional treatment with NSAIDs; with a history of long-standing headache and sporadic treatment. On examination: neurological: awake, facial asymmetry, dysarthria, decreased muscle strength in both lower limbs, no meningeal signs; the brain tomographic report without contrast indicated: expansive brain lesions of etiology to be determined at both sides of the diencephalon: rule out glioma vs aneurysms; cerebral Angiotac with contrast, reflects bilateral intracranial internal carotid and middle cerebral (mirror) aneurysms. Subsequently the patient was evaluated by the neurosurgeon on duty, who indicated to refer to a center of higher complexity, for not having the necessary instruments for surgery; patient died on the way to the referral center.  Conclusions: Being a rare pathology, it is not considered as a first option for diagnostic suspicion after a headache event.