SUBARACHNOID AND INTRAVENTRICULAR HEMORRHAGE CAUSED BY HYPERNEPHROMA METASTASIS, ACCOMPANIED BY INNOCENT BILATERAL POSTERIOR COMMUNICATING ARTERY ANEURYSMS

We present a case of subarachnoid and intraventricular hemorrhage due to an infratentorial metastasis of a renal cell carcinoma. The lesion was not apparent on initial magnetic resonance imaging (MRI) or in a f ollow-up examination (MRI and angiography) 6 weeks after the bleeding. The innocent bilateral posterior communicating artery aneurysms detec ted by cerebral angiography were treated surgically. The origin of the hemorrhage, however, remained unclear. Five months later, a surgicall y proven metastasis in the fourth ventricle subsequently gave the expl anation for the bleeding.