Multiple intracranial aneurysms and abdominal aortic occlusion in a young woman: A case report

Multiple intracranial aneurysms occur in 10% to 30% patients with cerebral aneurysms.

We reported a case of multiple intracranial aneurysms concurrent with abdominal aortic occlusion (AAO) in a 29-year-old woman was admitted because of abrupt onset of severe headache, vomiting, and dizziness for 26 hours. She complained sudden onset of severe headache, vomiting, and dizziness.

Head computed tomography (CT) angiogram revealed 2 aneurysms of the anterior communicating artery (ACA) and a third aneurysm at the right middle cerebral artery (MCA). A diagnosis of multiple intracranial aneurysms concurrent with abdominal aortic occlusion (AAO) was made.

We clipped the 2 aneurysms at the ACA via a right pterional approach. The transfemoral approach failed because of an unsuspected AAO. A right carotid artery approach was then employed to embolize the aneurysm at the right MCA with three coils.

Magnetic resonance angiography (MRA) at 7 days after the embolization demonstrated complete disappearance of all the intracranial aneurysms, but AAO was still present. The patient remained asymptomatic during 5-years of follow-up.

The case highlights the importance of a thorough physical examination, and in rare cases, AAO or other abdominal aortic abnormalities should be considered in young nonsmoking females. Successful treatment can be achieved by aneurysm clipping and embolization.