The authors have reported on 184 cases of aneurysms and have experienced rebleeding after clipping of the aneurysmal neck in seven cases. The causes of rebleeding in our series were local fragility in two (Case 1 and 3), HICH in two (Case 2 and 7), and new aneurysms in two (rt ACA in Case 5, It MCA in Case 6). The etiology was unknown in one (Case 4).
This time we are reporting two cases of rebleeding after clipping of the aneurysmal neck due to rupture of new aneurysms in other cerebral arteries.
Case 4. (45-years-old male): Rebleeding due to rupture of new aneurysm in the region of the right genu occurred 14 months after clipping of an aneurysmal neck of the right middle artery.
Case 6. (51-years-old male): Rebleeding due to rupture of a right middle cerebral artery aneurysm occurred 11 years after clipping of an aneurysmal neck in the region of the left genu.
In the former case, it seems that the changes of hemodynamic stress in addition to hypertension after occlusion of the right M1 due to vasospasm of the right middle cerebral artery were causative factors.
Similarily in the later case, a mini-aneurysm of the right middle cerebral artery which was undiscovered previously by the usual cerebral angiography, grew larger and ruptured after 11 years.
