Atypical Presentation of a Ruptured Anterior Communicating Artery Aneurysm With Subdural, Intraparenchymal, and Subarachnoid Hemorrhage.

Anterior communicating artery (ACom) aneurysm, one of the most frequent types of intracranial aneurysm rupture, usually results in a subarachnoid hemorrhage (SAH) with intraventricular hemorrhage. We describe a case of an ACom aneurysm rupture with subarachnoid, intraparenchymal, and subdural hemorrhages (SDH) with midline shift in a 55-year-old woman. Decompressive craniectomy was performed to evacuate the SDH with subsequent microsurgical clipping of the aneurysm.