Reports of thrombosis and recanalization of cerebral aneurysm are rare. We report two cases of small, saccular aneurysms in which spontaneous thrombosis had occurred during the preparation for endovascular coiling. Also, we review reported cases and propose the presumed pathogenesis.

ObjectiveThe aim of this study was to investigate the correlation between meteorological factors and occurrence of spontaneous intracerebral hemorrhage (ICH) according to age.Materials and MethodsWe retrospectively analyzed the records of 735 ICH patients in a metropolitan hospital-based population. Observed and expected numbers of ICH patients were obtained at 5℃ intervals of ambient temperature and a ratio of observed to expected frequency was then calculated. Changes in ambient temperature from the day before ICH onset day were observed. The Wilcoxon-Mann-Whitney test was used to test differences in meteorological variables between the onset and non-onset days. The Kruskal-Wallis test was used for comparison of meteorological variables across gender and age.ResultsICH was observed more frequently (observed/expected ratio ≥ 1) at lower mean, minimum, and maximum ambient temperature (p = 0.0002, 0.0003, and 0.0002, respectively). Significantly lower mean, minimum, and maximum ambient temperature, dew point temperature, wind speed, and atmospheric pressure (p = 0.0003, 0.0005, 0.0001, 0.0013, 0.0431, and 0.0453, respectively) was observed for days on which spontaneous ICH occurred. In the subgroup analysis, the ICH onset day showed significantly lower mean, minimum, and maximum ambient temperature, dew point temperature, relative humidity, and higher atmospheric pressure in the older (≥ 65 years) female group (p = 0.0093, 0.0077, 0.0165, 0.0028, 0.0055, and 0.0205, respectively).ConclusionOccurrence of spontaneous ICH is closely associated with meteorological factors and older females are more susceptible to lower ambient temperature.

The Sundt encircling clip was developed to repair defects of the vessel wall. With the advent of microvascular techniques, most parts of the damaged vessel wall during aneurysm surgery can be repaired by primary closure or by the bypass technique. However, these methods are not always successful. Here, we illustrate two cases of surgical clipping with the Sundt encircling clip in the ruptured internal carotid artery trunk aneurysm. The Sundt clip provides prompt control of unexpected tearing of the vessel wall or aneurysm and plays an important role in vascular rescue during aneurysm surgery.