Acute subdural hemorrhage caused by a ruptured intracranial aneurysm is a well-known association but usually linked to dismal outcome. We briefly reviewed the clinical and imaging features, surgical management and outcome of 45 patients with subdural bleeding related to intracranial aneurysm. Forty-two reports were encountered in the literature between 1981-2015 and three additional patients were identified in the author personal archives. A total of three patients had bilateral acute subdural hemorrhage, and the epidural hematoma was not present in any of the 45 reports. Coma was identified in 32/45 (71%) patients at admission. Only seven of 45 cases reported were managed by endovascular approach. A good clinical outcome was observed in 23/45 (51%) and early mortality occurred in 10/45 (22%) of the patients analysed. Neurosurgical management has evolved tremendously in recent years leading to more comprehensive understanding about this association. Factors leading to natural history, mechanisms, imaging aspects and improvement of clinical results of aneurysmatic subdural bleeding merit further studies
