PubMed1986
We report a case of five aneurysms, including three giant aneurysms, a pair of symmetric aneurysms, and two fusiform aneurysms. The initial clinical symptom was a cerebral ischemic attack. On admission, the patient complained of sudden onset of speech disturbance. Physical examination showed left hemiparesis. Radiological studies, including computed tomography and cerebral arteriography, revealed multiple low density areas bilaterally in the basal ganglia and three fusiform giant aneurysms bilaterally in the middle cerebral arteries and basilar artery. Considering the difficulty of surgical treatment, the patient was discharged. Six months later, complaining of right hemiparesis and total dysphasia, the patient was readmitted to our department. CT scan on admission revealed no changes except for ischemic changes. During the second admission, another attack of subarachnoidal hemorrhage due to rupture of the left middle cerebral artery aneurysm occurred, and the patient died. Autopsy was performed, and two more aneurysms, not visualized in the former studies, were found in the right anterior communicating artery and the cortical branch of the right middle cerebral artery. The occurrence of aneurysms in such a fashion as seen in the present case is to be very rare in the aspect of the size, the multiplicity and the bilaterally development.