2025 Volume 47 Issue 6 Pages 397-403
A 24-year-old woman presented to our hospital with occipital pain after urination at 16 weeks and three days of gestation. Simple magnetic resonance imaging revealed a subarachnoid hemorrhage (WFNS grade I, Hunt–Hess grade II, Fisher group 3), and the patient was treated together with an obstetrician and an anesthesiologist. Computed tomography angiography (CTA) revealed a suspected aneurysm in the anterior communicating artery, but it was not definitively diagnosed; therefore, cerebral angiography was conducted to evaluate the aneurysm. An extra-small aneurysm of the anterior communicating artery measuring 1.9 mm in maximal diameter was treated with coil embolization via the brachial artery approach to minimize radiation exposure in the lower abdomen. The treatment was completed without intraoperative rupture or cerebral infarction. The patient was discharged on the illness day 20. She delivered a healthy baby by cesarean section at 38 weeks and three days of gestation as scheduled without reoperation, and the mother and infant had an uneventful postoperative course. Examination and coil embolization of an extra-small cerebral aneurysm that ruptures during pregnancy can be a viable treatment option because it is a less invasive treatment for mothers and infants without the significant side effects of radiation and contrast media.
