Multiple Cerebral Aneurysms

multiple cerebral aneurysms
In this female patient who presented with subarachnoid hemorrhage, CTA shows two aneurysms arising from anterior communicating artery and basilar artery tip.

Intracranial aneurysms are multiple in 10-30% of all cases.About 75% of these cases have 2 aneurysms, 15% have 3, and 10% have more than 3.

Multiple aneurysms can be bilaterally symmetric (mirror aneurysms) or located asymmetrically on different vessels. More than one aneurysm can be present on the same artery.

A strong female predilection is observed.

Predisposing diseases include;
Polycystic kidney disease
Fibromuscular dysplasia
System lupus erythematosus
Ehlers-Danlos syndrome
Coarctation
Cerebral AVM

References:
1. Emedicine; 2007 : Cerebral aneurysms.
2. Dahnert; 2003 : Radiology Review Manual, Lippincott, Williams & Wilkins.
3. Osborn 1994: Diagnostic Neuroradiology. Mosby.

Credit: Dr Ahmed Haroun