Objective: Well-documented case reports of the rapid formation and rupture of de novo aneurysms of the posterior circulation are rare.
Clinical presentation: We report a patient with subarachnoid hemorrhage caused by an aneurysm of the anterior communicating artery that was clipped consecutively. Forty-four days after the initial subarachnoid hemorrhage, the patient experienced a second subarachnoid hemorrhage after the rupture of a newly grown aneurysm of the basilar tip. Between the two hemorrhages, transcranial Doppler sonography and neuroimaging revealed a fulminant generalized vasospasm.
Intervention: To our knowledge, this is the first report of the rapid development and rupture of a de novo aneurysm of the posterior circulation after the rupture of an initial aneurysm of the anterior circulation.
Conclusion: We review the pertinent literature and discuss possible reasons for the development and rupture of this second aneurysm.