Delayed re-bleeding of a spontaneously thrombosed aneurysm after subarachnoid hemorrhage Academic Article uri icon

abstract

  • BACKGROUND:

    This report provides a rare documentation of spontaneous thrombosis of a ruptured aneurysm followed by delayed recanalization and subsequent rerupture.

    CASE DESCRIPTION:

    A 47-year-old female presented with spontaneous subarachnoid hemorrhage (SAH). Four aneurysms were identified on CT angiogram including a basilar apex aneurysm, considered source of bleeding. Cerebral angiogram on postbleed day (PBD) #1 showed spontaneous thrombosis of basilar apex aneurysm. The patient was discharged to a nursing home on PBD #18 after two subsequent studies showed no recanalization of the basilar aneurysm. The patient returned on PBD #26 with a second episode of spontaneous SAH. The previously thrombosed basilar aneurysm had recanalized and reruptured, which was now treated with coil embolization.

    CONCLUSION:

    We are not aware of a previous report of saccular cerebral aneurysm documenting spontaneous thrombosis after SAH and recanalization with second hemorrhage. This occurrence presents a dilemma regarding the timing and frequency of subsequent cerebrovascular imaging and treatment.

    KEYWORDS:

    Aneurysm; embolization; recanalization; subarachnoid hemorrhage; thrombosis

    PMID: 24818049 [PubMed] PMCID: PMC4014823

publication date

  • 2014