Death associated with an unruptured giant intracranial aneurysm.

Deaths due to or associated with unruptured giant intracranial aneurysms are extremely rare. We describe a case of a sudden death associated with an unruptured giant vertebrobasilar aneurysm in a symptomatic 18-year-old male. Post-mortem examination revealed three giant fusiform and thrombosed aneurysms (vertebrobasilar junction, internal carotid arteries), an old infarct with some sub-acute changes in the brain stem and medulla, an incipient pneumonia, and a high blood alcohol concentration (2.4 o/oo). The association of these findings suggest the role of a multi-factorial respiratory dysfunction as a pathophysiological mechanism leading to death. In fatal cases related to giant intracranial aneurysm, a number of triggers and contributing factors, with potential medico-legal implications, must be appropriately considered in the chain of events leading to death.