Active bleeding from ruptured cerebral aneurysms during diagnostic angiography: emergency treatment.

Despite new developments in the treatment of cerebral aneurysms, recurrent hemorrhage of an aneurysm is the most feared complication of subarachnoid bleeding. The prognosis of patients with early reruptured aneurysms is discouraging. A rerupture of an aneurysm with active bleeding is extremely rare, and the mechanisms involved remain unclear. We report the management of active bleeding of reruptured aneurysms during diagnostic angiography. In two patients, emergency treatment of the active hemorrhage was performed by means of neurosurgical intervention and by an endovascular approach in one other case. The causes and management of reruptured aneurysms with active bleeding are also discussed within the context of a review of the literature.