Pathology of intracerebral hemorrhage in ruptured aneurysms of the posterior communicating artery at its origin from the internal carotid artery

There were thirty-two autopsied cases of ruptured aneurysms at the junction of the internal carotid and posterior communicating arteries in the file of Montefiore Medical Center from 1948 to 1983 (Table 1). The age range of the patients was 11-83 years. Seven were men and twenty-five were women. Fifteen had previous surgery; either clipping of the neck of the aneurysm or ligation of the common carotid artery. Analysis of the hemorrhage associated with the ruptured aneurysms revealed two distinct patterns. One is subarachnoid hemorrhage alone (18 cases) and another is subarachnoid hemorrhage and intraventricular rupture through the temporal horn (14 cases). These aneurysms did not produce a large intracerebral hematoma in the temporal lobe because they ruptured into the temporal horn. Among the post-operative cases (14 cases), only 3 cases had intraventricular hemorrhage. Correlation of these autopsy findings with CT Scans revealed that an intraventricular hematoma in the temporal horn could be interpreted as a large intracerebral hematoma in the temporal lobe.