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Updated: Jul 23, 2025
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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
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Sequential rupture of two concomitant cerebral aneurysms.
Joseph Yoon1, Ryan Goh1, Craig Winter1
1Kenneth Jamieson Department of Neurosurgery, Royal Brisbane and Women's Hospital, Brisbane, Australia.
British Journal of Neurosurgery
|July 12, 2023
Summary
A rare case of sequential aneurysmal subarachnoid hemorrhage (SAH) occurred in a young woman. She experienced a second SAH from a different cerebral aneurysm 16 days after the first, highlighting this uncommon phenomenon.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Neurology
Background:
- Multiple cerebral aneurysms are frequently diagnosed in patients with subarachnoid hemorrhage (SAH).
- Rupture of a second aneurysm during recovery from an initial bleed is exceptionally rare.
Purpose of the Study:
- To report a rare case of sequential aneurysmal subarachnoid hemorrhage.
- To contribute to the limited literature on simultaneous and sequential SAH.
Main Methods:
- Case report of a 21-year-old female with WFNS grade 1 SAH.
- Initial treatment involved clipping of a right posterior communicating artery aneurysm.
- Second SAH occurred 16 days later from a left anterior choroidal artery aneurysm, treated with coiling.
- Digital subtraction angiography was used for aneurysm comparison.
Main Results:
- The patient experienced two separate SAH events from distinct cerebral aneurysms within 16 days.
- The second aneurysm showed significant growth (from 2.7x2 mm to 4.4x2.3 mm) between events.
- Literature review on simultaneous and sequential SAH was conducted.
Conclusions:
- Sequential aneurysmal subarachnoid hemorrhage, though rare, can occur shortly after an initial event.
- This case underscores the importance of vigilance and potential for rapid aneurysm growth in specific clinical scenarios.
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