title: Simultaneous presentation of two cerebral aneurysms.
abstract: A 48-year-old woman experienced sudden onset of severe headache. Computed tomography showed subarachnoid hemorrhage (SAH) and intracerebral hematoma in the right frontal lobe. Digital subtraction angiography revealed three aneurysms in the anterior communicating artery (AcomA), the right posterior communicating artery (PcomA), and the right middle cerebral artery. The AcomA aneurysm was treated with endovascular coiling. However, her oculomotor nerve palsy was aggravated after the procedure. Embolization of the right PcomA aneurysm was conducted immediately and her oculomotor nerve palsy recovered completely 3 months later. Simultaneous presentation of multiple aneurysms with separate symptoms is rare. We speculate that the progressive oculomotor nerve palsy was caused by tiny enlargement or morphological change of the aneurysm caused by elevated blood pressure and pulsatile effect after SAH.
authors.affiliation: Department of Neurosurgery, Osaki Citizen Hospital, Osaki, Miyagi. m-ysd@ya2.so-net.ne.jp
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ezura
authors.forename: Kazuto
authors.initials: K
authors.lastname: Sasaki
authors.forename: Masashi
authors.initials: M
authors.lastname: Chonan
authors.forename: Masaki
authors.initials: M
authors.lastname: Mino
mesh_terms: D015901:Angiography, Digital Subtraction; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D004621:Embolization, Therapeutic; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D002532:Intracranial Aneurysm / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000209:etiology; D019233:Retreatment; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D014057:Tomography, X-Ray Computed