A CHALLENGING CASE OF HEMORRHAGIC STROKE IN A PATIENT WITH FUSIFORM ANEURYSM WITH PARTIAL THROMBOSIS: A CASE REPORT

Background:This is a unique case where two hypertension induced complication were seen in same patient but thrombosis in aortic aneurysm has opposite treatment to that of cerebellar hemorrhage which are to be managed simultaneously. Such cases can come in future clinical practice as prevalence of hypertension is on rise.

Case presentation:In this case the patient was known case of hypertension since 8 years under treatment. Due to hypertension there was bleeding in bilateral cerebellar hemorrhage with seepage into fourth ventricle. This lead to symptoms of headache, imbalance while walking, nausea, vomiting.Mass effect was noted in form of mild compression over fourth ventricle. In this case CT Thorax showed fusiform dilatation of arch of aorta with non enhancing eccentric mural thrombi within, noted just distal to origin of left subclavian artery extending upto thoracic aorta, but this was an accidental finding not the source of emboli. The treatment became challenging as treating the Thrombus with anti-coagulants could lead to increase in the risk of bleeding from the hemorrhage and leaving it could lead to increase in chances of an Cardio embolic Ischemic stroke. Hence a fine line of balance had to be found in the treatment of this two Opposite conditions uniquely found in one patient.

Conclusion: Conclusion is that this is a case of cerebellar hemorrhage due to hypertension associated with fusiform aortic arch aneurysm with partial thrombosis. The treatment of both of this complicationsis opposite, hence the treatment needs to be done very carefully. This case report provides insight on management of such cases