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Meningioma associated with aneurysm and subarachnoid hemorrhage: case report and review of the literature.

A patient presented with spontaneous subarachnoid hemorrhage after a prolonged episode of coughing. A preoperative computed tomographic (CT) scan confirmed subarachnoid hemorrhage, but demonstrated no other lesion. Arteriography revealed an ophthalmic artery aneurysm. Operation revealed the aneurysm to be intracavernous without sign of prior rupture; however, a small hemorrhagic meningioma was removed from the ipsilateral anterior clinoid process. In this case, coincidental meningioma and aneurysm presented as a subarachnoid hemorrhage secondary to tumor hemorrhage. The follow-up of cases of subarachnoid hemorrhage with negative arteriography with sequential CT scans is discussed.