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Neurology India
Medknow Publications on behalf of the Neurological Society of India
ISSN: 0028-3886 EISSN: 1998-4022
Vol. 59, Num. 5, 2011, pp. 790-790

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
2 National Hospital Organization Disaster Medical Center, Tokyo, Japan
Correspondence Address: Satoru Takeuchi, Department of Neurosurgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan, s.takeuchi@room.ocn.ne.jp

Code Number: ni11245

PMID: 22019685

DOI: 10.4103/0028-3886.86581

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.

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

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  [PUBMED]  [FULLTEXT]

Copyright 2011 - Neurology India  

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