Introduction. In about one-third of the patients with aneurysmal subarachnoid
bleeding, multiple intracranial aneurysms are confirmed. Risk factors such
as female gender, smoking, hypertension, and age over 60 tend to be
associated with multiple aneurysms. In this paper, we also discuss family
predisposition and the treatment approach for multiple cerebral aneurysms.
Case outline. Here, we present a case of a female patient, 64-year-old, with
spontaneous subarachnoid hemorrhage that had nine intracranial aneurysms.
The patient was treated for hypertension for a longer period, excessive
smoker, and two of her nearest members of the family died from intracranial
bleeding. The patient was fully conscious, without any neurological
impairment. Subarachnoid bleeding was diffuse and nor brain-computer
tomography finding nor digital subtraction angiography couldn't suggest the
source or location of bleeding among nine presented aneurisms. Magnet
resonance imaging had to be done, and the T1W fast spin-echo sequence showed
a 9 mm large ruptured an aneurysm at the basilar tip, after contrast
application, beside others. Three days after insult endovascular
embolization was done and two basilar aneurysms were excluded from the
circulation, including the one that bled. Conclusion. The patient had the
majority of risk factors for multiple intracranial aneurysms. Knowledge of
the family predisposition of multiple intracranial aneurysms allowed us to
make proper diagnostics of a patient's descendant and reveal a new patient.
Risk Factors for Hemorrhagic Complications following Pipeline Embolization Device Treatment of Intracranial Aneurysms: Results from the International Retrospective Study of the Pipeline Embolization Device