Basilar Artery Bifurcation Aneurysm: Spontaneous SAH and Recurrent Aneurysm Rupture During Computed Tomography Angiography

  • Georg GihrEmail author
  • Franziska Dorn
  • Hans Henkes
Living reference work entry


A 70-year-old female patient experienced a spontaneous subarachnoid hemorrhage (SAH) due to the rupture of an irregular-shaped saccular aneurysm of the basilar artery (BA) bifurcation. Upon admission, her condition was equivalent to Hunt and Hess III with a Fisher grade of IV. During computed tomography angiography (CTA) with IV contrast medium infusion, her clinical condition deteriorated. CTA revealed a ruptured BA bifurcation aneurysm and massive contrast medium extravasation into the subarachnoid space due to the re-rupture of said aneurysm. A ventricular drain was inserted, and the aneurysm was occluded with coils as an emergency procedure. Severe posthemorrhagic vasospasm occurred during the further course, and the patient suffered multiple hemispheric infarctions and eventually passed away. Recently, more and more cases of early aneurysm re-rupture during CTA have been described in the literature. Whether this is a matter of a mere coincidence or related to the general circumstances or even CTA-induced is a matter of controversy. Whether CTA has to be regarded as a risk factor for early aneurysm re-rupture is not yet known. Early aneurysm re-rupture during CTA is the main topic of this chapter.


Basilar artery bifurcation aneurysm Computed tomography angiography, CTA Risk of re-rupture Coil occlusion Clipping AcomA aneurysm Vasospasm 


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© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Neuroradiologische Klinik, NeurozentrumKlinikum StuttgartStuttgartGermany
  2. 2.Institut für NeuroradiologieKlinikum der Universität MünchenMünchenGermany

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