Small retinal hemorrhages as the only sign of an intracranial aneurysm.

PURPOSE: To report a woman with two small circumpapillary and nerve fiber layer hemorrhages found on routine examination. METHODS: Case report. The patient had a history of severe headache 2 weeks previously but no other symptoms or signs. RESULT: Magnetic resonance imaging showed an intracranial aneurysm. CONCLUSIONS: This potentially lethal abnormality should be considered with small unexplained retinal hemorrhages, even when the neurologic examination is normal. A history of recent headache should be sought.