Abstract
Introduction. Intracranial aneurysms associated with Behçet's disease (BD) are a rare occurrence. They are fragile, thin-walled pseudoaneurysms, which have high tendency to rupture and present a therapeutic challenge. Case Presentation. We report a 26-year-old male with BD presented with subarachnoid hemorrhage due to ruptured middle cerebral artery aneurysm. Additionally, two unruptured aneurysms were identified. He underwent endovascular embolization using Onyx with successful obliteration of the ruptured aneurysm. Medical therapy resulted in regression of one and resolution of the other aneurysms. Conclusion. We describe the first report of the application of Onyx for obliteration of ruptured cerebral aneurysm in BD as a feasible and safe therapeutic option for patients who are not candidates for other techniques.
Highlights
Intracranial aneurysms associated with Behcet’s disease (BD) are a rare occurrence
We describe a patient with BD who experienced a subarachnoid hemorrhage (SAH) secondary to a ruptured right fusiform middle cerebral artery (MCA) aneurysm associated with multiple aneurysms of the anterior and posterior circulations
He was treated by endovascular embolization of the ruptured aneurysm, for the first time in the literature to our knowledge, using liquid embolic agent Onyx with successful preservation of the parent artery; medical therapy followed for the asymptomatic smaller aneurysm
Summary
Behcet’s disease (BD) is a multisystem inflammatory disorder of unknown etiology characterized by recurrent oral and genital ulcerations, optic manifestations of uveitis, iritis, and retinitis, and dermatological manifestations of erythema nodosum and pseudofolliculitis [1]. The most important morbidity encountered during the disease progression is vascular involvement with overall incidence of 7–29% [2]. We describe a patient with BD who experienced a subarachnoid hemorrhage (SAH) secondary to a ruptured right fusiform middle cerebral artery (MCA) aneurysm associated with multiple aneurysms of the anterior and posterior circulations. He was treated by endovascular embolization of the ruptured aneurysm, for the first time in the literature to our knowledge, using liquid embolic agent Onyx (an ethylene vinyl alcohol copolymer) with successful preservation of the parent artery; medical therapy followed for the asymptomatic smaller aneurysm
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