Concurrent aneurysm rupture and thrombosis of high grade internal carotid artery stenosis: report of two cases.
BACKGROUND
The simultaneous presentation of aneurysmal subarachnoid hemorrhage and thrombosis of a high-grade internal carotid artery stenosis is rare, and their management raises several treatment dilemmas.


METHODS
Two such patients with ruptured aneurysms are presented: one with high-grade internal carotid artery stenosis that progressed to occlusion and one with acute internal carotid artery occlusion.


RESULTS
Both patients were treated with craniotomy for clipping of the ruptured aneurysm followed by carotid thromboendarterectomy.


CONCLUSIONS
We advocate urgent surgical treatment of both lesions, dealing with the most symptomatic lesion first. These two cases demonstrate the importance of reestablishing blood flow in patients with an acutely thrombosed carotid artery.
Porter
R W
RW
Barrow Neurological Institute, Division of Neurological Surgery, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013-4496, USA.
Lawton
M T
MT
Hamilton
M G
MG
Spetzler
R F
RF
D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000150:complications* / Q000601:surgery; D002533:Cerebral Angiography; D004691:Endarterectomy; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D002542:Intracranial Embolism and Thrombosis / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed