Giant distal anterior cerebral artery aneurysm not visualized on angiography: Case report

Farias, João Paulo; Trindade, A.

doi:10.1016/s0090-3019(96)00417-x

Cited by 20 publications

(14 citation statements)

References 6 publications

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“…19) Only four of the 15 reported cases of giant pericallosal artery aneurysms were completely thrombosed. 2,10,12,14) Three cases of totally thrombosed pericallosal aneurysms were examined by only conventional angiography and CT. 10,12,14) Totally thrombosed giant pericallosal artery aneurysm was initially identified as callosal hematoma secondary to cavernous malformation or glioma even though angiography and MR imaging had been performed. 2) In all four cases, surgical exploration was the only way to make the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…1,4,5,[8][9][10]18,19) Giant pericallosal artery aneurysms are rarer, with only 15 cases reported. 1,2,[5][6][7][8][9][10][12][13][14][15]17,18,20) Giant aneurysms show a high incidence of thrombus formation, which causes difficulties in the differential diagnosis between giant aneurysms and other mass lesions including hematomas associated with vascular malformation and tumors based on cerebral angiography, computed tomography (CT), and magnetic resonance (MR) imaging. 2,10,12,14) We report a case of almost totally thrombosed giant pericallosal artery aneurysm that appeared to be recurring hematoma originating in a cavernous malformation or an avascular tumor with obliteration of the pericallosal artery on cerebral digital subtraction angiography (DSA), CT angiography, and MR imaging.…”

Section: Introductionmentioning

confidence: 99%

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Thrombosed Giant Aneurysm of the Pericallosal Artery With Inconclusive Findings of Multiple Neuroimaging Studies -Case Report-

Park

Chung

Shin

et al. 2008

Neurol. Med. Chir.(Tokyo)

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A 65-year-old woman presented with a thrombosed giant pericallosal artery aneurysm manifesting as headache and memory loss that developed over a 2-year period. Computed tomography (CT), magnetic resonance (MR) imaging, and conventional and CT angiography could not establish the differential diagnosis. Open craniotomy revealed the mass as thrombosed giant aneurysm from the pericallosal artery. Direct clipping with thrombectomy was performed successfully with an uneventful postoperative course. Thrombosed giant aneurysm of the distal anterior cerebral artery should be considered in the differential diagnosis of an unusual mass in the mid-frontal area, particularly in the presence of inconclusive angiographic and MR imaging findings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Thrombosed Giant Aneurysm of the Pericallosal Artery With Inconclusive Findings of Multiple Neuroimaging Studies -Case Report-

Park

Chung

Shin

et al. 2008

Neurol. Med. Chir.(Tokyo)

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“…Thirty of the 33 cases were treated surgically, and the neck was clipped in 13 of them. [7910131518212627313234] Only four cases were treated with bypass surgery, and good outcomes were obtained in all of them. The first bypass surgery, including aneurysm resection and end-to-end anastomosis of ACA, was reported in 1982.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, 32 cases have been reported, including only 3 cases treated with bypass surgery. [3–79–131517–2123–2729–3234]. …”

Section: Introductionmentioning

confidence: 99%

Thrombosed giant aneurysm of the distal anterior cerebral artery treated with aneurysm resection and proximal pericallosal artery-callosomarginal artery end-to-end anastomosis: Case report and review of the literature

Matsushima

Kawashima²,

Suzuyama³

et al. 2011

Surg Neurol Int

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Background:Giant distal anterior cerebral artery (DACA) aneurysms are extremely rare, with only 32 cases reported in the literature. Most giant DACA aneurysms have features that make standard neck clipping difficult, and bypass surgery is sometimes required, although this surgery was performed in only three reported cases. This report presents the fourth case treated with bypass surgery.Case Description:A 69-year-old female presented with an unruptured thrombosed giant DACA aneurysm. She underwent wrapping operation 7 years before, but radiological imaging revealed enlargement of the aneurysm at the left pericallosal artery (PerA)–callosomarginal artery (CMA) junction. Before operation, three different strategies were considered for bypass surgery in case the neck could not be clipped. Aneurysm resection and left proximal PerA–CMA end-to-end anastomosis were successfully performed under intraoperative digital subtraction angiography (DSA) and motor-evoked potential (MEP) monitoring.Conclusion:Most DACA aneurysms are located at the PerA–CMA junction. In some cases, adequate retrograde flow to the distal PerA from the posterior or middle cerebral artery can be expected, making distal PerA reconstruction unnecessary. Moreover, when the distal PerA is cut, proximal PerA–CMA end-to-end anastomosis can be easily performed because of reduced tension in both vessels. We therefore conclude that this strategy should be utilized for treating such patients. We also presented here the effectiveness of intraoperative modalities, such as intraoperative DSA and MEP monitoring, for performing a safe operation.

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“…11) The incidence of aneurysms of the distal ACA is low, and giant aneurysms of the distal ACA are rare, 5) with only 11 cases reported previously. 2,4,5,7,[9][10][11][12]15) We describe the serial neuroimaging findings of a distal ACA aneurysm which grew from a small saccular to a giant aneurysm in 36 months.…”

Section: Introductionmentioning

confidence: 99%

Serial Neuroimaging of a Growing Thrombosed Giant Aneurysm of the Distal Anterior Cerebral Artery. Case Report.

Kaneko

Nomura

Yamashima

et al. 2001

Neurol. Med. Chir.(Tokyo)

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An 81-year-old female presented with a giant aneurysm of the distal anterior cerebral artery (A 3 ) which grew from a small saccular aneurysm to a huge aneurysm within 36 months before manifesting as a mass lesion. The thrombosed portion of the aneurysm showed growth, whereas the aneurysmal cavity did not change in size. Computed tomography and magnetic resonance imaging showed new bleeding in the thrombosed portion. Hemorrhage into the thrombus and/or aneurysmal wall might have caused the aneurysmal growth. She refused surgery and was discharged with no deficits. Distal anterior cerebral artery aneurysm which shows neuroimaging signs of growth requires regular follow up as such lesions may become giant before manifesting clinical symptoms.

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Giant distal anterior cerebral artery aneurysm not visualized on angiography: Case report

Cited by 20 publications

References 6 publications

Thrombosed Giant Aneurysm of the Pericallosal Artery With Inconclusive Findings of Multiple Neuroimaging Studies -Case Report-

Thrombosed Giant Aneurysm of the Pericallosal Artery With Inconclusive Findings of Multiple Neuroimaging Studies -Case Report-

Thrombosed giant aneurysm of the distal anterior cerebral artery treated with aneurysm resection and proximal pericallosal artery-callosomarginal artery end-to-end anastomosis: Case report and review of the literature

Serial Neuroimaging of a Growing Thrombosed Giant Aneurysm of the Distal Anterior Cerebral Artery. Case Report.

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