Figure 2. Forty-four-year-old male experienced a sudden loss of consciousness following intense bouts of coughing. (a) and (b) He was diagnosed with ruptured 1.5 cm left PCOM aneurysm causing intraventricular, intracerebral, and subdural hemorrhage. (c) Lateral view of a follow-up DCA post-surgical aneurysm reconstruction and decompressive hemicraniectomy showing complete aneurysm obliteration. (d) Axial view of a non-contrast CT head day 1 post op shows decompression of the brain without a midline shift and a 3 cm epidural hematoma. (e) A follow-up non-contrast CT head four days post op showed increasing brain edema with midline shift, extensive bilateral cerebral infarcts with extension of the infarct into the bilateral occipital.