Abstract
Aortic coarctation is a common congenital cardiovascular anomaly, usually located at the aortic isthmus. It is associated with an increased risk of intracranial aneurysms, which may rupture and lead to subarachnoid hemorrhage (SAH), particularly in the setting of long-standing proximal arterial hypertension. We present the case of a 17-year-old adolescent who was admitted with severe SAH (modified Fisher grade IV) secondary to a ruptured basilar trunk aneurysm, which was treated by endovascular coil embolization. Post-embolization investigations revealed severe arterial hypertension, prompting further vascular imaging. Thoracic computer tomography angiography showed a tight stenosis of the descending thoracic aorta consistent with postductal coarctation, with extensive collateral circulation. This case underscores the importance of considering aortic coarctation in young patients presenting with intracranial aneurysm or SAH and highlights the pivotal role of cross-sectional imaging in the diagnostic workup.