RESUMO
Acute Subdural Hematoma [aSDH] due to aneurysm rupture and no subarachnoid bleeding are very rare with only 29 cases reported in literature. A 56-year female presented with headache and drowsiness and a previous history of loss of consciousness. Clinical examination revealed a GCS of 14 and a right sided hemiparesis. Workup revealed a pure subdural hematoma due to a middle cerebral artery aneurysm rupture with no subarachnoid hemorrhage. Laboratory workup was otherwise normal and she had no history of falls or head trauma consistent with the usual etiology of an aSDH. She underwent evacuation of the hematoma with clipping of the aneurysm. She had an uneventful recovery with good outcome and no residual neurological deficits at one-year follow-up