What are the clinical presentation of patients with ICMAs?
The clinical presentation of patients with ICMAs is highly variable. Patients may develop severe headache, altered sensorium, or focal neurological deficits such as hemianopsia or cranial neuropathies. Neurological signs and symptoms are nonspecific and may suggest a mass lesion or an embolic. Some ICMAs leak slowly before rupture and produce mild meningeal irritation. Frequently, the spinal fluid in these patients is sterile, and it usually contains erythrocytes, leukocytes, and elevated protein. In other patients, there are no clinically recognized premonitory findings before sudden subarachnoid or intraventricular hemorrhage.