Leukomalacia with ruptured saccular aneurysm

I. Ahmed and J. Sher

A 42-year-old woman with a ruptured saccular aneurysm of the internal carotid artery developed large areas of cerebral leukomalacia, resulting in hemiparesis and an obtunded mental state. A significant factor in the development of the white matter lesions was episodic hypotension, leading to reduced cerebral blood flow in a patient whose cerebral circulation was already compromised by vasospasm secondary to the subarachnoid hemorrhage. This case illustrates yet another clinical situation associated with the development of white matter necrosis.