• Shuta Aketa, Daisuke Wajima, Taekyun Kim, Rinsei Tei, and Taiji Yonezawa.
• Department of Neurosurgery, Osaka Police Hospital, Tennoji, Osaka, Japan.
• World Neurosurg. 2016 Sep 1; 93: 488.e9-488.e12.

BackgroundThere is no published report of ruptured cerebral aneurysm accompanied by target vessel occlusion. We present a case of ruptured basilar tip aneurysm with concomitant basilar artery (BA) occlusion.Case DescriptionA 53-year-old man presented to our emergency room with the acute onset of disturbance. Plain head computed tomography showed diffuse subarachnoid hemorrhage. Computed tomography angiography and digital subtraction angiography showed a BA tip aneurysm with BA trunk occlusion. Endovascular treatment with mechanical thrombectomy using a stent retriever and coil embolization was performed. Clinical and radiologic results were good. The patient was discharged 30 days after onset (modified Rankin Scale score = 1).ConclusionsWe were able to recanalize the BA trunk and perform coil embolization of the ruptured BA tip aneurysm. Our case is the first published report of a ruptured aneurysm with target large-vessel occlusion. Awareness of the issues raised in this case is required to determine the best treatment strategy, and preoperative consideration allows neurointerventionalists to avoid unpleasant surprises in the angiography suite.Copyright © 2016 Elsevier Inc. All rights reserved.

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