Acute thrombosis and recanalization of a ruptured anterior communicating artery aneurysm

A 35-year-old man sustained a subarachnoid hemorrhage due to the rupture of an anterior communicating artery aneurysm. A second angiogram taken 8 hours later demonstrated that the ruptured aneurysm had thrombosed spontaneously with a small residual aneurysm stump at the neck. CT scans and conventional angiograms taken 2 days later demonstrated recanalization of the aneurysm, which was successfully treated by endovascular coiling. This case differs from previous reports of spontaneously thrombosed ruptured aneurysms because the aneurysm recanalized within 2 days. Thus a thrombosed ruptured aneurysm has the potential for recanalization, and should be considered at risk of further hemorrhage.