Spontaneous Thrombosis of Basilar Artery Aneurysm After Subarachnoidal Hemorrhage in a Patient With Thrombophilia and Recurrent Deep Venous Thrombosis

Abstract

We report a patient with combined thrombophilia--protein C deficiency and mild hyperhomocysteinemia with total spontaneous thrombosis of a basilar tip aneurysm after subarachnoid hemorrhage, without neurological deficit. At admission, the patient had headache, drowsiness, and nausea, with no neurological deficit. Computed tomography (CT) did not show the presence of subarachnoid blood, and magnetic resonance examination revealed discrete remains of a subarachnoid hemorrhage in projections of temporal, frontal and occipital lobes, with no vascular abnormalities. Initial angiography showed a small basilar tip aneurysm and the patient was scheduled for endovascular treatment. A second angiography, performed before the planned endovascular treatment, did not show the aneurysm and complete thrombosis was suspected. A follow-up angiogram, 6 months after this event, showed preserved posterior cerebral circulation with no aneurysm present. The patient was discharged in good condition, without neurological deterioration. We did not find any previous reports of similar conditions.

Delayed Massive Traumatic Hematoma in the Corpus Callosum: Two Case Reports with Literature Review

“…However, we could not entirely eliminate the possibility of traumatic aneurysm bleeding because the diagnostic accuracy of CTA may not allow detection of abnormalities of peripheral cerebral arteries (like our case 2) and spontaneous thrombosis of small intracranial aneurysms. 22) We could not pinpoint one particular factor responsible for the delayed hematoma. However, continuous headaches after discharge was observed in case 1, and this symptom may have been indicative of subtle intracranial hemorrhage and subsequently with progressive dizziness.…”

Transpetrosal Approach to a Ruptured Distal Basilar Perforating Artery Aneurysm

“…This is likely attributable to acute thrombosis of the aneurysm after rupture. The incidence of thrombosis of small ruptured aneurysms has been shown to be 1%-2% [ 18 ]. In general, extremely small caliber aneurysms, such as basilar perforator aneurysms, are often characterized by reduced flow, facilitating partial or complete thrombosis [ 16 , 18 , 19 ].…”

“…The incidence of thrombosis of small ruptured aneurysms has been shown to be 1%-2% [ 18 ]. In general, extremely small caliber aneurysms, such as basilar perforator aneurysms, are often characterized by reduced flow, facilitating partial or complete thrombosis [ 16 , 18 , 19 ]. This underscores the importance of close in-hospital observation of these patients and the utility of short-interval repeat DSA, especially if there is a considerable blood burden in the subarachnoid space.…”