Abstract
We present a case of a 44-year-old woman admitted to our hospital with severe headache. Computed tomography (CT) showed diffuse SAH. Three dimensional CT angiography revealed that the right internal carotid artery distal to the ophthalmic artery, was fenestrated and had two aneurysms. Clipping of the ruptured right aneurysms was performed. Intraoperative findings revealed that the wall of the aneurysm was very thin. There was another unruptured aneurysm at the left internal carotid artery. One month after the first operation, we operated on the unruptured contralateral aneurysm uneventfully. She was discharged with no neurological deficit. A supraclinoid fenestrated internal carotid artery with an aneurysm is very rare. An aneurysm may occur when a fenestrated vessel wall becomes thin. When we operate on aneurysms association with fenestrated vessels, caution is needed during the clipping procedure.
