Intraventricular haemorrhage due to ruptured posterior inferior cerebellar artery aneurysm in tuberculous meningitis

A 9-year-old Asian boy with known miliary tuberculosis, tuberculous meningitis and hydrocephalus was successfully treated with chemotherapy and ventriculoperitoneal shunting, but re-presented 7 months later with an intraventricular haemorrhage secondary to a ruptured left posterior inferior cerebellar artery mycotic aneurysm. The aneurysm was successfully treated by craniotomy and clipping. Tubereulous mycotic intracranial aneurysms are rare, but they should be considered in patients with tuberculous meningitis, particularly when there is a rapid neurological deterioration which may represent rupture.