title: Acute formation of a pseudoaneurysm adjacent to a previously clipped anterior communicating artery aneurysm.
abstract: BACKGROUND
  Cerebral pseudoaneurysms, especially of the anterior communicating artery (ACoA), are rare.
  
  
  METHODS
  Herein, the authors report a 66-year-old patient who underwent successful clip ligation of a small ruptured ACoA aneurysm. Eighteen days after surgery, he suffered from another episode of subarachnoid hemorrhage due to the rupture of a newly formed pseudoaneurysm adjacent to the previously clipped aneurysm. This pseudoaneurysm was treated through clip ligation as well.
  
  
  CONCLUSIONS
  A pseudoaneurysm may rarely form adjacent to a previously clipped cerebral aneurysm and should be included in the differential diagnosis of recurrent subarachnoid hemorrhage. Potential mechanisms of formation and management strategies for this challenging problem will be discussed.
authors.affiliation: Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mohammadali M
authors.initials: MM
authors.lastname: Shoja
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: Aaron A
authors.initials: AA
authors.lastname: Cohen-Gadol