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|Year : 2011 | Volume
| Issue : 5 | Page : 790
Report of a patient with 13 intracranial aneurysms
Satoru Takeuchi1, Yoshio Takasato2
1 Department of Neurosurgery, National Defense Medical College, Saitama, Japan
2 National Hospital Organization Disaster Medical Center, Tokyo, Japan
|Date of Web Publication||22-Oct-2011|
Department of Neurosurgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Takeuchi S, Takasato Y. Report of a patient with 13 intracranial aneurysms. Neurol India 2011;59:790
One third of intracranial aneurysms are multiple. The reported number of aneurysms vary between 2 and 8. ,, 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. ,, 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.  Further investigations on the methods of determining the site of aneurysm rupture are required.
| » References|| |
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|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. |
|3.||Nehls DG, Flom RA, Carter LP, Spetzler RF. Multiple intracranial aneurysms: Determining the site of rupture. J Neurosurg 1985;63:342-8. |