Case Report: Meningioma with Intra-tumoural Haemorrhage Secondary to Ruptured Distal Anterior Cerebral Artery Aneurysm

Background: Brain tumours that are associated with cerebral aneurysms are rare occurrences, whereas the coexistence of brain tumours and intra-tumoural aneurysms is even rarer. There have been 12 brain tumour cases that have been reported in the literature that describe an aneurysm within a brain tumour, with 4 of these tumours being meningiomas. Case description: A 34-year-old male patient presented with sudden-onset headache, and an inter-hemispheric meningioma with intra-tumoural bleeding was found due to a ruptured embedded anterior cerebral artery aneurysm. The aneurysm was diagnosed incidentally on the third cerebral angiogram, while the initial 2 angiograms were negative. The patient was treated with endovascular aneurysm embolisation that was followed by tumour resection. Conclusion: This paper is the first case report to describe the coexistence of a meningioma and an aneurysm, which presented with intra-tumoural haemorrhage that was negative on the initial cerebral angiogram. Unlike previous case reports, the aneurysm in this case was located with an anterior cerebral artery distribution.