Simultaneous occurrence of aneurysmal subarachnoid hemorrhage (SAH) and hypertensive intracerebral hemorrhage (ICH) is very rare and only two cases have been previously reported in the literatures. We present a case of 68-yr-old man with a history of untreated hypertension, who suffered from sudden onset of headache followed by right hemiparesis. Computed tomographic (CT) scan revealed SAH in the basal cistern and remote ICH at the left putamen. Cerebral angiography showed a saccular aneurysm at the anterior communicating artery. No other vascular anomaly could be found at left putaminal area. Nine days after the ictal attack of SAH, the neck of aneurysm was clipped via the left frontotemporal craniotomy. Because of the ICH at the left frontal lobe and intraventricular hematoma on postoperative CT, we performed hematoma removal and external ventricular drainage 3 hours after the first operation. Postoperative neurological status had been improved to be drowsy and he was discharged in a severely disabled state 4 weeks after surgery. We suggest that the rupture of aneurysm possibly caused a rapid increase in blood pressure and subsequently resulted in hypertensive ICH.
Aged ; Aneurysm, Ruptured/*complications/radiography/surgery ; Carotid Arteries/radiography ; Humans ; Intracranial Hemorrhage, Hypertensive/*complications/radiography/surgery ; Male ; Putaminal Hemorrhage/*complications/radiography/surgery ; Subarachnoid Hemorrhage/*etiology/radiography/surgery ; Tomography, X-Ray Computed

A pulmonary artery aneurysm is a common manifestation and the leading cause of mortality in Behcet's disease. We describe a case of spontaneous rupture of a pulmonary artery aneurysm that, due to the inadequacy of medical therapy and the disadvantages of surgery, became the ideal candidate for endovascular management and was successfully performed by using the Amplatzer Vascular Plug 4.
Adult ; Aneurysm, Ruptured/*radiography/*surgery ; Behcet Syndrome/*complications ; Humans ; Iopamidol/analogs & derivatives/diagnostic use ; Male ; *Pulmonary Artery ; Radiography, Thoracic ; *Septal Occluder Device ; Tomography, X-Ray Computed

Behcet's disease has been recognized as a systemic vasculitis characterized by the involvement of multiple organs such as orogenital ulcers, eye lesions including uveitis and optic neuritis, and skin lesions including folliculitis and erythema nodosum. Vascular involvement occurs occasionally and is classified into thrombosis and aneurysm. However, massive gastrointestinal bleeding from arterial aneurysm is a rare manifestation of intestinal Behcet's disease. Recently, we experienced a case of intestinal Behcet's disease presenting with massive gastrointestinal bleeding due to aneurysmal rupture of ileo-colic artery. A 30-year-old male with Behcet's disease was admitted because of massive gastrointestinal bleeding. A large ileo-cecal ulcer was revealed as a bleeding focus on colonoscopic examination. Celiac angiography showed aneurysm and stenosis of ileo-colic artery. After the failure of hemostasis with arterial embolization, ileocecectomy was performed. After the resection hematochezia was completely stopped.
Adult ; Aneurysm, Ruptured/complications/*diagnosis ; Behcet Syndrome/complications/*diagnosis ; Cecum/*blood supply/pathology/surgery ; Celiac Artery/radiography ; Colonoscopy ; Gastrointestinal Hemorrhage/*diagnosis/etiology ; Humans ; Ileum/*blood supply/pathology/surgery ; Male ; Tomography, X-Ray Computed