Ischemic Stroke as a Warning Sign of Impending Aneurysmal Rupture: A Report of Two Cases

• OKAMURA Kazuaki

  Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

• MOROFUJI Yoichi

  Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

• IZUMO Tsuyoshi

  Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

• SATO Kei

  Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

• FUJIMOTO Takashi

  Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

• HORIE Nobutaka

  Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

• MATSUO Takayuki

  Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

Abstract

Ischemic stroke associated with intracranial aneurysm is rare but potentially happens because of emboli originating from aneurysm sac or aneurysmal thrombosis extension to the parent artery. We describe two patients who present subarachnoid hemorrhage (SAH) soon after ischemic stroke. Case 1. A 51-year-old woman with a history of multiple endovascular therapy for ruptured basilar top aneurysm presented with double vision. Magnetic resonance imaging (MRI) revealed infarcts in the right thalamus and left occipital cortex. Four days after ischemic stroke, she suffered from sudden onset headache, computed tomography (CT) showed diffuse SAH with intraventricular hemorrhage. Case 2. A 62-year-old man presented with right facial palsy and sensory disorder. MRI revealed an infarct in the left pons. Four days after ischemic stroke, he became comatose and CT showed diffuse SAH. Both cases develop ischemic stroke adjacent to the aneurysms and subsequently cause devasting aneurysm rupture, suggesting ischemic stroke as a warning sign of aneurysm rupture. In such cases, early treatment of the aneurysm should be considered.

Journal

• NMC Case Report Journal

  NMC Case Report Journal 8 (1), 85-88, 2021

  The Japan Neurosurgical Society

Keywords

• aneurysm
• hemodynamic-induced inflammation
• ischemic stroke
• subarachnoid hemorrhage
• warning sign

Details

• CRID: 1390005822567130752
• NII Article ID: 130007995210
• DOI: 10.2176/nmccrj.cr.2020-0040
• ISSN: 21884226
• Web Site: https://www.jstage.jst.go.jp/article/nmccrj/8/1/8_cr.2020-0040/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2022000504
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed