Abstract
In this paper, we report a case of multiple aneurysms associated with dural arteriovenous malformation and occlusion of cerebral arteries.
A 53-years-old man was transfered to our hospital for detail examination of a subarachnoid hemorrhage (SAH). An angiogram showed three aneurysms on the left frontopolar artery accompanied by occlusion of the left callosomarginal artery, of the left middle cerebral artery and dural arteriovenous malformations between the ethmoid artery and the olfactory vein.
On Nov. 5, 1981, 14 days after the episode of SAH, a bifrontal craniotomy was performed for removal of the arteriovenous malformation and clipping of aneurysm necks. The third aneurysm was so small and broad-based that we decided to encase it with a piece of muscle and adhesive Alon α A®.
Follow up angiography revealed a remarkable increase in the size of the encased aneurysm. On the day following angiography, the patient died of massive bleeding from the aneurysm.
Based on the histopathological examination of this case, we recommend that an aneurysm coexisting with a arteriovenous malformation and occlusion of the main artery be treated by clipping or ligation applied adequately to the aneurysm neck.
