BRAIN - Multiple Aneurysm

This shows part of the base of the brain cut to display an aneurysm, approximately 2 x 1 cm, on the right middle cerebral artery. In relation to the larger aneurysms there is an area of softening, close by and remnants of subarachnoid haemorrhage. On the reverse side, the specimen shows right-sided swelling.
This man presented at the age of 43 with a subarachnoid haemorrhage; initially his condition was precarious, but he improved over the next 12 hours; bilateral carotid angiography showed bilateral cerebral aneurysms and the right, which was the largest, was thought to be the site of the bleed. Seven days later the aneurysm was clipped; for the first 12 hours his condition was excellent, but over the next 12 hours his condition deteriorated, with the clinical picture of pan-cerebral spasm.