CONCURRENT ANEURYSM RUPTURE AND THROMBOSIS OF HIGH-GRADE INTERNAL CAROTID-ARTERY STENOSIS - REPORT OF 2 CASES

BACKGROUND The simultaneous presentation of aneurysmal subarachnoid he morrhage and thrombosis of a high-grade internal carotid artery stenos is is rare, and their management raises several treatment dilemmas. ME THODS Two such patients with ruptured aneurysms are presented: one wit h high-grade internal carotid artery stenosis that progressed to occlu sion and one with acute internal carotid artery occlusion. RESULTS Bot h patients were treated with craniotomy for clipping of the ruptured a neurysm followed by carotid thromboendarterectomy. CONCLUSIONS We advo cate urgent surgical treatment of both lesions, dealing with the most symptomatic lesion first. These two cases demonstrate the importance o f reestablishing blood flow in patients with an acutely thrombosed car otid artery. (C) 1997 by Elsevier Science Inc.