The association of cerebral angiomas with intracranial aneurysms.

The symptoms separately associated with both intracranial aneurysms and angiomas are well understood and their diagnosis now presents no special problem. Rarely the two lesions may coexist, sometimes with confused symptoms, or, when intracranial haemorrhage is the presenting symptom, with the precise source of haemorrhage in doubt. Walsh and King (1942) recorded the first case of an associated angioma and aneurysm, since when 13 further examples have appeared in the literature. In this paper three new cases are reported and the previous literature reviewed; a distinction is made between a true arterial aneurysm coexisting with an angioma, and the aneurysmal sac which is part of the malformation itself. Cases in the latter category are excluded. Suggestions are made as to the nature of the association of the two lesions, and the clinical significance of their association described. Case 1, which presented with subarachnoid haemorrhage, is of special interest because arteriography clearly demonstrated which lesion had bled.