Complete spontaneous thrombosis and recanalization of a ruptured posterior cerebral artery aneurysm

Abstract

Complete spontaneous thrombosis followed by recanalization of non-giant aneurysms is a rare event that can be discovered incidentally on advanced neural images. In this case report, the authors described a woman who presented with subarachnoid hemorrhage (SAH) and left posterior cerebral artery (PCA) territory ischemic stroke. Cerebral angiography revealed a left PCA aneurysm at the P1-P2 junction. The patient received conservative treatment and repeated cerebral angiography 4 weeks later demonstrated the disappeared aneurysm. Subsequent magnetic resonance imaging (MRI) and contrast-enhanced computed tomography (CT) demonstrated the totally thrombosed aneurysm with hydrocephalus. Ventriculo-peritoneal shunt surgery for hydrocephalus was performed and the patient noted a great improvement of the neurological deficit. Follow-up contrast-enhanced CT after 10 weeks revealed recurrence of the aneurysm. This case provides insight into the natural dynamic process of intracranial aneurysm, and a complete thrombosed aneurysm has the potential for recanalization.