title: [Magnetic resonance vessel wall imaging reveals rupture site in subarachnoid hemorrhage with multiple cerebral aneurysms].
abstract: We report a case of subarachnoid hemorrhage(SAH)with multiple cerebral aneurysms, in which magnetic resonance vessel wall imaging(MR-VWI)revealed the rupture site. A 68-year-old woman presented with SAH. Computed tomography(CT)showed diffuse SAH(Fisher group 3). 3D-CT angiography revealed two intracranial aneurysms:a 4.2-mm anterior communicating artery aneurysm(Acom An)and a 5.8-mm basilar tip aneurysm(BAtip An). As the BAtip An was the larger of the two, it was deemed the most likely site of rupture;however, high-resolution MR-VWI with gadolinium showed thick wall enhancement in the Acom An and no enhancement in the BAtip An. Thus, we performed a craniotomy for the Acom An. Intraoperative findings confirmed the rupture site at the Acom An. We concluded that high resolution MR-VWI may be useful for identifying the rupture site in patients with spontaneous SAH and multiple cerebral aneurysms.
authors.affiliation: Department of Neurosurgery, Yamagata City Hospital SAISEIKAN.
authors.forename: Rei
authors.initials: R
authors.lastname: Kondo
authors.forename: Tetsu
authors.initials: T
authors.lastname: Yamaki
authors.forename: Wataru
authors.initials: W
authors.lastname: Mouri
authors.forename: Shinji
authors.initials: S
authors.lastname: Sato
authors.forename: Shinjiro
authors.initials: S
authors.lastname: Saito
authors.forename: Morio
authors.initials: M
authors.lastname: Nagahata
authors.forename: Satoko
authors.initials: S
authors.lastname: Nagahata
authors.forename: Takamasa
authors.initials: T
authors.lastname: Kayama
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D002533:Cerebral Angiography; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome