Systemic multiple aneurysms of the intracranial arteries and visceral arteries: case report

Systemic multiple aneurysms are rare, and an association between intracranial aneurysms and visceral aneurysms is an extremely rare occurrence.

This 56-year-old woman was referred to our hospital with subarachnoid hemorrhage. Physical examination revealed no particular morphologic features suggesting connective tissue diseases. Cerebral angiography demonstrated two aneurysms of the left internal carotid artery and the right middle cerebral artery. The internal carotid artery aneurysm was occluded surgically. Four days later, she had right hemiparesis and mild aphasia due to cerebral vasospasm. While she was started on hemodynamic therapy and the administration of thromboxane A2 synthetase inhibitor for cerebral vasospasm, she suffered intraabdominal hemorrhage due to the rupture of the visceral artery aneurysms, and was treated with emergency surgery.

The hemodynamic therapy and the administration of thromboxane A2 synthetase inhibitor for symptomatic vasospasm may have precipitated the rupture of the intraabdominal aneurysm.