Recurrent subarachnoid hemorrhage caused by a de novo basilar tip aneurysm developing within 8 weeks after clipping of a ruptured anterior communicating artery aneurysm: case report

Abstract

Objective: Well-documented case reports of the rapid formation and rupture of de novo aneurysms of the posterior circulation are rare.

Clinical presentation: We report a patient with subarachnoid hemorrhage caused by an aneurysm of the anterior communicating artery that was clipped consecutively. Forty-four days after the initial subarachnoid hemorrhage, the patient experienced a second subarachnoid hemorrhage after the rupture of a newly grown aneurysm of the basilar tip. Between the two hemorrhages, transcranial Doppler sonography and neuroimaging revealed a fulminant generalized vasospasm.

Intervention: To our knowledge, this is the first report of the rapid development and rupture of a de novo aneurysm of the posterior circulation after the rupture of an initial aneurysm of the anterior circulation.

Conclusion: We review the pertinent literature and discuss possible reasons for the development and rupture of this second aneurysm.