Cerebral hemorrhage produced by ruptured dissecting aneurysm in miliary aneurysm

This report describes, for what may be only the second time, a ruptured miliary aneurysm within a cerebral hemorrhage. The report is unique in that the aneurysm has arisen at the site of a dissection within the wall of an arteriole at a site of fibrinoid necrosis. The case not only is a unique illustration of this pathogenetic pathway to miliary aneurysm formation, but also reemphasizes the relationship between fibrinoid and miliary aneurysm formation.