Recurrent subarachnoid hemorrhage caused by a de novo basilar tip aneurysm developing within 8 weeks after clipping of a ruptured anterior communicating artery aneurysm: case report.

Abstract

Well-documented case reports of the rapid formation and rupture of de novo aneurysms of the posterior circulation are rare. We report a patient with subarachnoid hemorrhage caused by an aneurysm of the anterior communicating artery that was clipped consecutively. Forty-four days after the initial subarachnoid hemorrhage, the patient experienced a second subarachnoid hemorrhage after the rupture of a newly grown aneurysm of the basilar tip. Between the two hemorrhages, transcranial Doppler sonography and neuroimaging revealed a fulminant generalized vasospasm. To our knowledge, this is the first report of the rapid development and rupture of a de novo aneurysm of the posterior circulation after the rupture of an initial aneurysm of the anterior circulation. We review the pertinent literature and discuss possible reasons for the development and rupture of this second aneurysm.