engleski

A rare case of multiple unruptured intracranial aneurysms

Introduction/Objectives: Incidence of multiple intracranial aneurysms is 20-30% in the general population. Most patients have two aneurysms that are usually localized in internal carotid artery and middle cerebral artery. The localization of aneurysm may be associated with etiology and asymmetric location of aneurysms is mainly associated with acquired causes. The largest number of aneurysms are not clinically manifested until they rupture but a small number of aneurysms may be presented with the symptoms related to the expansion of the aneurysm. Case report: A 73-year-old woman presented to the neurological department of Pula General Hospital with a subacute onset of headache, without relief after painkillers. The patient also describes chronic headaches of lighter intensity. There were no accompanying vegetative symptoms. She was previously healthy with occasionally higher blood pressure and has never been neurologically treated. Neurological examination on admission was completely normal. The patient underwent emergency neuroradiological examination. Native MSCT scan of the brain showed expansive hyperdense formations in the area of the left cavernous sinus and in the supasellar area. MSCT angiography revealed multiple unruptured aneurysms of both internal carotid and middle cerebral arteries, anterior and posterior communicating arteries and in transition of basilar to posterior cerebral artery. Conclusions: Due to the many risks associated with the surgical treatment cerebral aneurysms are a major challenge, especially if multiple and distant to each other. Commonly, one bigger aneurysm is symptomatic and others are diagnosed accidentally. Each of the multiple aneurysms can rupture and cause SAH. Due to this fact, it is necessary to recognize if there is a bleeding aneurysm and according to this plan intervention in the appropriate time period. Multiplicity of aneurysms does not diminish the importance of surgical treatment, but it's complete solving is less frequent than in solitary aneurysms

aneurysm ; angiography ; SAH

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