Coexistence of Brain Metastasis and Ruptured Intracranial Aneurysm

Abstract

Introduction: The coexistence of brain metastasis and ruptured intracranial aneurysm is a rare, but clinically significant condition due to its high morbidity and mortality. This combination poses diagnostic and therapeutic challenges, especially in resource-limited regional hospitals.

Case presentation: We report the case of a 64-year-old woman with radiological diagnosis of a brain tumor suspected to be metastatic. During tumor resection, an unexpected subarachnoid hemorrhage occurred, attributed to the intraoperative rupture of a previously undiagnosed aneurysm. A subsequent cerebral angio-CT scan revealed two intracranial aneurysms. Histopathology confirmed a metastatic brain adenocarcinoma. Discussion: Although rare, the coexistence of brain tumors and aneurysms has been reported, particularly with primary tumors such as meningiomas or pituitary adenomas. This case highlights the need for preoperative angiographic studies in patients with brain tumors and the importance of basic neurosurgical equipment in regional hospitals. Conclusion: In low-resource settings, timely identification and management of coexisting lesions such as brain metastases and ruptured aneurysms is essential to improve surgical outcomes. This case underscores the need for comprehensive diagnosis and investment in neurosurgical infrastructure.