# Multiple Intracranial Aneurysms Associated With Brain Arteriovenous Malformation: A Case Report and Treatment Strategies

## TL;DR

This case report discusses a complex situation involving multiple brain aneurysms and a malformation, emphasizing the need for tailored treatment strategies.

## Contribution

The paper presents a unique case combining multiple intracranial aneurysms with a BAVM and discusses treatment challenges and strategies.

## Key findings

- A 29-year-old patient had a ruptured ACoA aneurysm, an unruptured ophthalmic artery aneurysm, and a frontal BAVM.
- Treatment strategies for flow-related aneurysms in BAVMs require careful consideration of the rupture site and customized approaches.
- The case highlights the importance of identifying the exact rupture source to guide optimal treatment decisions.

## Abstract

In the field of cerebrovascular neurosurgery, intracranial aneurysms (IAs) have been occasionally associated with brain arteriovenous malformations (BAVMs), indicating a more aggressive clinical course, and increased rates of hemorrhage and rehemorrhage. Treatment of flow-related IAs in BAVMs remains debatable, with considerations for preventive intervention versus concurrent BAVM treatment. Managing such situations might be challenging, especially in determining which of the IAs or BAVMs should be treated first, and which treatment strategy would be most appropriate for each situation. A precise identification of the rupture site is required, whether it is the AVM nidus or the IA, for choosing the best treatment plans. We present a case of a 29-year-old male patient diagnosed with several intracranial vascular conditions: a ruptured anterior communicating artery (ACoA) aneurysm and an unruptured ophthalmic artery aneurysm, associated with a frontal BAVM. Moreover, we discussed the possible scenarios regarding the association of these conditions, highlighting their manifestations and the most suitable therapeutic approach for each. Thus, our exploration of the challenges and considerations involved in treating these intricate neurovascular conditions underscores the need for a customized approach for each patient’s situation.