PMC7332489_01
Preoperative axial computed tomography (CT) (a) demonstrating subarachnoid haemorrhage. Three-dimensional reconstructed CT angiogram (b) showing a large internal carotid- posterior communicating artery aneurysm with a bleb (arrow).
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F1
Head computed tomography revealed SAH, and computed tomography arteriogram showed a carotid-posterior communicating artery aneurysm with a bleb [Figure 1].
Electrocardiogram on admission.
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F2
Continuous ECG monitoring on admission showed sinus tachycardia (mean: 120 beats/min) with frequent ventricular premature complexes [Figure 2].
Preoperative (a) and postoperative (b) left internal carotid artery angiogram (frontal view). The low flow in the internal carotid-posterior communicating artery aneurysm (arrow) disappeared after endovascular treatment.
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F3
The patient agreed to endovascular treatment to prevent rebleeding, and coil embolization for the ruptured aneurysm was performed under general anesthesia on postbleed day (PBD 1) [Figure 3].
Electrocardiogram in the intensive care unit showing bradycardia and repetitive transient severe asystole.
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F4
Worsening bradycardia and repetitive transient asystole lasting 3-12 s with hypotension occurred during postoperative care in the intensive care unit [Figure 4].