Multiple peripheral middle cerebral artery aneurysms associated with Behcet's disease

Area of Science:

• Neurology
• Vascular Surgery
• Rheumatology

Background:

• Behcet's disease is a rare systemic vasculitis that can affect arteries, including cerebral arteries.
• Cerebral aneurysms are a serious complication, potentially leading to subarachnoid hemorrhage.
• Management of aneurysms in the context of active vasculitis presents unique challenges.

Observation:

• A 19-year-old woman with Behcet's disease presented with subarachnoid hemorrhage and bilateral peripheral middle cerebral artery aneurysms.
• Initial treatment with corticosteroids for 3 days led to the resolution of a smaller aneurysm.
• The larger aneurysm required surgical intervention.

Findings:

• Surgical excision of the larger aneurysm was performed, followed by arterial reconstruction using a superficial temporary artery graft.
• Histological examination confirmed vasculitis localized to the aneurysm wall.
• This case represents the first reported instance of arterial reconstruction for an aneurysm associated with Behcet's disease.

Implications:

• Preoperative steroid therapy may play a role in facilitating arterial wall repair in Behcet's disease patients.
• This case expands treatment options for cerebral aneurysms in patients with systemic vasculitis.
• Further research is warranted to explore the efficacy of steroid therapy in managing vascular complications of Behcet's disease.