Association of Multiple Cerebral Aneurysms and Cerebral Arteriovenous Malformation: Case Report and Review of the Literature*

The incidence of aneurysmal subarachnoid hemorrhage is about 10-11 cases per 100,000 inhabitants. The true incidence of multiple aneurysms is not known, however, according to previous studies it may vary between 20% and 30%. The association of arteriovenous malformation and cerebral aneurysm is well documented and varies between 20% and 30%. A case is described of a 47-year-old female presenting with massive acute subarachnoid hemorrhage. Computed tomography and cerebral panangiography revealed seven saccular aneurysms (five along the left anterior cerebral artery and its branches, one at the left M1/2 junction, and one in the anterior communicating artery), and an arteriovenous malformation involving the left frontal and parietal lobe fed mostly by the left anterior cerebral artery. Neurosurgeons clipped all seven aneurysms and then the arteriovenous malformation was extirpated.