Re-Recurrence of Intracranial Aneurysm with Proximal Vascular Stenosis After Primary Clipping and Secondary Endovascular Embolization: A Case Report and Literature Review

BACKGROUND: It was known that a small number of patients could have intracranial aneurysm recurrences after either surgical clipping or endovascular embolization treatment. However, early recurrence within 1 month after the treatment and re-recurrence has rarely been reported before. CASE DESCRIPTION: We report a 46-year-old man with a medical history of smoking and hypertension who was noncompliant with the treatments. He presented to the hospital with right extremity paralysis and aphasia and was found to have a ruptured middle cerebral artery aneurysm. Aneurysm was successfully treated by surgical clipping. Within 1 month after the treatment, the patient had a recurrent aneurysm at the same location and intracranial hemorrhage. The recurrent aneurysm was treated by endovascular embolization. However, during the follow-up visit 8 months after the treatment, angiography showed aneurysm recurrence with proximal vascular stenosis. CONCLUSIONS: Re-recurrence of intracranial aneurysm could happen after initial successful treatment with surgical clipping and endovascular embolization. In addition to the patient's medical history and characteristics of the aneurysm, local vascular stenosis might also contribute to its recurrence. Close postoperative follow-up is required for these patients.