A 39-year-old woman experienced a sudden severe crushing headache associated with neck pain and stiffness, blurred vision and severe photophobia. CT scan showed no evidence of a significant bleed, but there were RBC's in the cerebrospinal fluid on lumbar puncture. MRI (shown) showed evidence of an aneurysm of the circle of Willis.
Magnetic resonance angiogram (MRA) showed an 8mm berry aneurysm at the junction of the left middle cerebral artery (MCA) and posterior communicating (PCOM).
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