Woman With Sudden-Onset Headache M. Yashar S. Kalani, MD, PhD, Robert F. Spetzler, MD  Annals of Emergency Medicine  Volume 68, Issue 3, Pages e69-e70 (September 2016) DOI: 10.1016/j.annemergmed.2016.02.012 Copyright © 2016 American College of Emergency Physicians Terms and Conditions

Figure 1 Axial CT shows intraparenchymal (solid white arrow), subdural (dashed white arrow), and subarachnoid hemorrhage (blue arrow). Used with permission from Barrow Neurological Institute, Phoenix, AZ. Annals of Emergency Medicine 2016 68, e69-e70DOI: (10.1016/j.annemergmed.2016.02.012) Copyright © 2016 American College of Emergency Physicians Terms and Conditions

Figure 2 Coronal CT angiogram shows extravasation of contrast and blood from a posterior communicating artery aneurysm (dashed arrow) into the subdural space (solid arrow). Used with permission from Barrow Neurological Institute, Phoenix, AZ. Annals of Emergency Medicine 2016 68, e69-e70DOI: (10.1016/j.annemergmed.2016.02.012) Copyright © 2016 American College of Emergency Physicians Terms and Conditions

Figure 3 Intraoperative photograph after an orbitozygomatic craniotomy, with the Sylvian fissure split, demonstrates microsurgical clipping of the aneurysm (arrow). Used with permission from Barrow Neurological Institute, Phoenix, AZ. Annals of Emergency Medicine 2016 68, e69-e70DOI: (10.1016/j.annemergmed.2016.02.012) Copyright © 2016 American College of Emergency Physicians Terms and Conditions

Figure 4 Postoperative axial CT angiogram documents obliteration of the aneurysm (arrow). Used with permission from Barrow Neurological Institute, Phoenix, AZ. Annals of Emergency Medicine 2016 68, e69-e70DOI: (10.1016/j.annemergmed.2016.02.012) Copyright © 2016 American College of Emergency Physicians Terms and Conditions