• Yuanhong Ge, Qingjia Lai, Wenyu Wang, and Xuejun Xu.
• Department of Neurosurgery, Chengdu Second People's Hospital.
• Medicine (Baltimore). 2021 Jun 4; 100 (22): e26228e26228.

RationaleObstructive hydrocephalus (OH) frequently occurs in patients with a ruptured cerebral aneurysm (CA), and it may lead to severe neurological deficits, including life-threatening brain herniation. OH generally occurs in the early stage of CA rupture, rather than in the late stage, and rarely resolves without therapy.Patient ConcernsA 64-year-old woman with a ruptured anterior communicating artery aneurysm was treated with coil embolization. Nineteen days after her CA rupture, because of the delayed transient OH, she experienced a dramatic cycle in consciousness over 9 hours: wakefulness-drowsiness-coma-drowsiness-wakefulness.DiagnosisThe patient was diagnosed with delayed transient obstructive hydrocephalus, which is a very rare condition.InterventionsMannitol was administered to reduce intracranial pressure.OutcomesThe patient was discharged from the hospital 30 days after admission, with a final GCS score of 15 and without weaknesses. At follow-up 2 months after discharge, brain CT revealed non-recurrence of hydrocephalus.LessonsA blood clot of any size in the ventricle is likely to lead to obstructive hydrocephalus. Prolonged bed rest for IVH patients may help to reduce the incidence of delayed OH.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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