MIRROR IMAGE SUBARACHNOID HAEMORRHAGE: AN UNUSUAL PRESENTATION OF INTERNAL CAROTID ARTERY ANEURYSM

We report a case of a patient who was referred to us for the treatment of right internal carotid supraclionoid aneurysm with subarachnoid haemorrhage on right side. In the evening before surgery, the patient had severe headache and loss of consciousness. Computed tomography scan of head revealed subarachnoid haemorrhage on the left side. A suspicion of a mirror aneurysm arose. Patient underwent digital subtraction angiography which showed same right internal carotid artery supraclionoid aneurysm which had increased in size. This is the first description of mirror subarachnoid haemorrhage which happened with a single aneurysm and is different from mirror aneurysm. The aneurysm was treated with endovascular coiling. A review of pathophysiology, radiological imaging, clinical manifestations and management is presented and discussed.