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NEUROIMAGE
Year : 2011  |  Volume : 59  |  Issue : 5  |  Page : 790

Report of a patient with 13 intracranial aneurysms


1 Department of Neurosurgery, National Defense Medical College, Saitama, Japan
2 National Hospital Organization Disaster Medical Center, Tokyo, Japan

Date of Web Publication22-Oct-2011

Correspondence Address:
Satoru Takeuchi
Department of Neurosurgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.86581

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How to cite this article:
Takeuchi S, Takasato Y. Report of a patient with 13 intracranial aneurysms. Neurol India 2011;59:790

How to cite this URL:
Takeuchi S, Takasato Y. Report of a patient with 13 intracranial aneurysms. Neurol India [serial online] 2011 [cited 2019 Jul 21];59:790. Available from: http://www.neurologyindia.com/text.asp?2011/59/5/790/86581


One third of intracranial aneurysms are multiple. The reported number of aneurysms vary between 2 and 8. [1],[2],[3] This report presents a patient with 13 intracranial aneurysms.

A 76-year-old woman presented with a sudden onset of severe headache and altered mental status. She had a past history of cerebral infarction and no family history of subarachnoid hemorrhage (SAH). On admission, she was deeply comatosed. Brain computed tomography (CT) revealed SAH [Figure 1]a. Cerebral angiography demonstrated 13 cerebral aneurysms: 2 in the right internal carotid artery (ICA) and 2 in the right middle cerebral artery (MCA) [Figure 1]b; 2 in the left ICA, 2 in the left anterior cerebral artery and 1 in the left MCA [Figure 1]c; and 1 in the right vertebral artery (VA), 2 in the left VA, 1 in the basilar artery, and 1 in the left posterior cerebral artery [Figure 1]d. No therapeutic intervention was done because of her poor general condition. Two months later, she died following recurrent aneurysmal rupture. Autopsy revealed the ruptured aneurysm in the left ICA [[Figure 1]c, arrow] with no abnormal findings in other organs.
Figure 1: (a) CT showing subarachnoid hemorrhage. (b) Cerebral angiograms demonstrating 13 aneurysms: (b) 3 in the right anterior circulation, (c) 5 in the left anterior circulation, and (d) 5 in the posterior circulation. Arrow heads, aneurysms; arrow, ruptured aneurysm

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Probably this patient is the first case with 13 documented intracranial aneurysms in the literature. [1],[2],[3] In our patient, it was difficult to identify the aneurysm that bled as there were no lateralizing features on CT. Retrospectively, one of the aneurysm on the left ICA might have been the ruptured aneurysm. [3] Further investigations on the methods of determining the site of aneurysm rupture are required.

 
  References Top

1.Baumann F, Khan N, Yonekawa Y. Patient and aneurysm characteristics in multiple intracranial aneurysms. Acta Neurochir Suppl 2008;103:19-28.  Back to cited text no. 1
[PUBMED]    
2.Sato O, Kanazawa I, Kokunai T, Kobayashi M. Seven intracranial aneurysms of the internal carotid arteries. Diagnosis by magnification angioautotomography. Neuroradiology 1978;15:189-92.  Back to cited text no. 2
[PUBMED]    
3.Nehls DG, Flom RA, Carter LP, Spetzler RF. Multiple intracranial aneurysms: Determining the site of rupture. J Neurosurg 1985;63:342-8.  Back to cited text no. 3
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