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Neurology India, Vol. 59, No. 5, September-October, 2011, pp. 790 Neuroimage Report of a patient with 13 intracranial aneurysms Satoru Takeuchi1, Yoshio Takasato2 1 Department of Neurosurgery, National Defense Medical College, Saitama, Japan PMID: 22019685 DOI: 10.4103/0028-3886.86581 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. 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
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