Clinical History

A woman of 56-years was admitted following 2 episodes of severe headache with loss of consciousness. Clinical examination revealed systemic hypertension with cardiac enlargement, and a right hemiparesis. Angiography showed bilateral middle cerebral aneurysms. The patient's condition deteriorated, and she died soon after admission.

Pathology

The left hemisphere of the brain has been sliced in the parasagittal plane, and the cut surface displays a large cerebral haemorrhage in the parietal and frontal lobe. The haemorrhage and associated clot are causing extensive distortion of the left external capsule and lateral ventricle. The source of the bleeding was a ruptured aneurysm of the left middle cerebral artery.