[Behçet's disease associated with multiple cerebral aneurysms and downhill esophageal varices caused by superior vena cava obstruction: a case report].

A 62-year-old woman who had suffered from Behçet disease since 1975 was admitted to Kawasaki Municipal Hospital because of severe headache and consciousness disturbance in July 1988. The emergency brain CT scan showed subarachnoid hemorrhage. Despite clipping the neck of the cerebral aneurysm, she died of cerebral herniation. Post-mortem examination revealed four aneurysms on the anterior part of the circle of Willis: 1) at the first bifurcation of the right middle cerebral artery 2) at the bifurcation of the left internal carotid artery 3) at the anterior communicating artery 4) at the left middle cerebral artery. The complete obstruction of the superior vena cava and downhill esophageal varices with no evidence of portal hypertension were also observed. This case had downhill esophageal varices induced by vena caval obstruction as a quite rare symptom of vasculo-Behçet's disease and also complicated with congenital multiple aneurysms of cerebral arteries.