Recurrent arterial aneurysm ruptures in neurofibromatosis type 1: A case report

Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder associated with vascular lesions, including arterial aneurysms and ruptures. Although arterial ruptures have been reported at several sites, repeated ruptures are extremely rare. A 51-year-old woman with NF1 developed a ruptured internal thoracic artery aneurysm 5 years following a vertebral artery aneurysm rupture. She presented with sudden-onset left-sided neck and back pain. Contrast-enhanced computed tomography revealed a left internal thoracic artery aneurysm with active extravasation and massive hemothorax. She underwent successful coil embolism following intubation and was discharged ambulatory on day 37. This case highlights the need for careful long-term vascular surveillance in patients with NF1, even after the initial aneurysm rupture. The occurrence of sudden-onset pain should prompt suspicion of aneurysm rupture.