Polyarteritis rarely involves the cerebral vasculature, and has not been reported to have an initial presentation with intracerebral aneurysms. We describe the first case of polyarteritis presenting with symptomatic intracerebral aneurysms. A literature review from 1966 to 1997 identified 5 additional cases with evidence of intracerebral aneurysms and polyarteritis. The cases reviewed all had evidence of longstanding systemic symptoms suggestive of polyarteritis prior to diagnosis. Polyarteritis with intracerebral aneurysms is associated with significant morbidity and mortality, and therefore must be recognized and treated early.
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