Extremely rare complication of granulomatosis with polyangiitis Aneurysmal subarachnoid haemorrhage

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Oguz Baran
Selçuk Ozdogan
Nail Demirel
Sevket Evran
Hanife Gulden Duzkalir
Ayhan Kocak

Abstract

The systemic vasculitis of the small-medium arteries, arterioles, venules and rarely large arteries that involves respiratory system and kidneys was defined as Granulomatosis with Polyangiitis (GPA) disease by Wegener in 1936. Intracranial aneurysms and subarachnoid haemorrhage (SAH) are extremely rare complications of GPA and our case will be the 2nd case treated with clipping aneurysm and the 11th case with subarachnoid haemorrhage in the literature.


A 43-year-old man presented to the emergency room with a severe headache and was admitted for further evaluation. He had GPA diagnosis 14 years ago with cytoplasmic anti-neutrophil cytoplasmic antibody (C-ANCA) and PR3-ANCA positive laboratory tests and kidney biopsy. SAH was seen on cranial computed tomography (CT) images. Then cerebral digital substraction angiography (DSA) performed and right middle cerebral artery aneurysm exposed. Aneurysm was clipped without any complication.


Intracranial aneurysms and SAH are extremely rare complications of GPA. GPA related aneurysmal SAH is an exceptional condition in neurovascular pathology. Monitoring patients with GPA for SAH must be remembered and kept in mind as a diagnosis.

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How to Cite
Baran, O., Ozdogan, S., Demirel, N., Evran, S., Duzkalir, H., & Kocak, A. (2019). Extremely rare complication of granulomatosis with polyangiitis. Romanian Neurosurgery, 33(4), 438-442. https://doi.org/10.33962/roneuro-2019-069
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Author Biographies

Oguz Baran

Department of Neurosurgery, Haseki Research and Training Hospital, Istanbul, Turkey

Selçuk Ozdogan

Department of Neurosurgery, Haseki Research and Training Hospital, Istanbul, Turkey

Nail Demirel

Department of Neurosurgery, Haseki Research and Training Hospital, Istanbul, Turkey

Sevket Evran

Department of Neurosurgery, Haseki Research and Training Hospital, Istanbul, Turkey

Hanife Gulden Duzkalir

Department of Neurosurgery, Kartal Dr. Lutfi Kirdar Research and Training Hospital, Istanbul, Turkey

Ayhan Kocak

Department of Neurosurgery, Haseki Research and Training Hospital, Istanbul, Turkey