[Magnetic resonance vessel wall imaging reveals rupture site in subarachnoid hemorrhage with multiple cerebral aneurysms]

No Shinkei Geka. 2014 Dec;42(12):1147-50. doi: 10.11477/mf.1436200050.
[Article in Japanese]


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.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / etiology
  • Aneurysm, Ruptured / surgery*
  • Cerebral Angiography
  • Diagnostic Imaging*
  • Female
  • Humans
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / surgery*
  • Magnetic Resonance Imaging
  • Subarachnoid Hemorrhage / diagnosis
  • Subarachnoid Hemorrhage / etiology
  • Subarachnoid Hemorrhage / surgery*
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome