Subarachnoid hemorrhage in a patient with multiple aneurysms: Case report and review of the literature.

Solapas principales

López J.1, Sánchez K.1, Custodio J.1, Lock W.1



            The subarachnoid hemorrhage represents a still devastated stroke type. Within this context, the presence of multiple aneurysms in one patient occurs in a few percentage of cases and most of the time is a challenge to identify the ruptured aneurysm to achieve a successful treatment and outcome. This case describes a young female patient with delayed identification of subarachnoid hemorrhage and four cerebral aneurysms diagnosed by CTangio and rotational angiography, without identifying which was the ruptured. Microsurgical clipping in two times found in the first surgery, that the anterior communicating aneurysm was responsible for the bleeding with good clinical outcome of the patient at discharge and late follow up. In times where endovascular therapy is increasingly used, improvements in techniques and equipments mean that microsurgical clipping is still an effective technique in the management of multiple cerebral aneurysms in the setting of a subarachnoid hemorrhage without precise identification of the origin of the bleeding.


Key Words: Multiple aneurysms. Clipping. Subarachnoid hemorrhage.

  1. Servicio de Neurocirugía de la Clínica Internacional sede San Borja, Lima, Perú