A case of the tiny aneurysm on the basilar apex which was considered to be ruptured on VWI and treated with horizontal stent technique

Abstract

Discrimination of a tiny ruptured aneurysm from non-aneurysmal subarachnoid hemorrhage (SAH) is sometimes difficult. We report a case of aneurysm on the basilar apex of a patient with SAH who was treated with stent-assisted coil embolization. A 48-year-old female presented with SAH. A tiny and broad neck aneurysm was detected at the apex of the basilar artery. Because it was uncertain that the aneurysm caused SAH, the patient received conservative therapy under sedation. Follow-up angiography revealed no other aneurysms, and the enhancement of the aneurysmal wall was seen in MRI VWI. We conducted stent-assisted coil embolization on the 17th day after the onset. The postoperative prognosis was favorable, and the patient was discharged without symptoms. MRI VWI was useful in deciding on the treatment. A “horizontal stent” may be suitable for tiny basilar apex aneurysms.