Giant fusiform aneurysm of the cerebral arteries.

Abstract

SUMMARY Giant fusiform aneurysm of the cerebral arteries was found in 11 patients during a 20-year period. The 7 males and 4 females ranged in age from 9 to 68 years (mean: 49 years). The supraclinoid segment of the internal carotid artery (ICA) and the M-1 segment of the middle cerebral artery (MCA) were the most frequently inrolred arteries. Multiple aneurysms were identified in 3 patients. Compression of adjacent intracranial structures was the usual cause of symptoms, and only 2 patients experienced subarachnoid hemorrhage. One patient presented with transient ischemic attacks. Computed tomography, with and without Hypaque infusion, clearly demonstrated the aneurysms in the 6 of 7 patients studied. Thrombus was invariably seen in the lumen of the aneurysm. Cerebral angiography in 11 patients displayed marked dilatation and elongation of the inrolred artery. The dilatation frequently extended into connecting arteries. Surgical treatment was carried out in 6 patients, including 2 with aneurysm entrapment and decompression, 2 with proximal ICA ligation, 1 with wrapping and 1 with wrapping and superficial temporal artery (STA) to MCA anastomosis. Death occurred in 2 patients not treated surgically. Stroke, Vol 12, No 2, 1981 GIANT FUSIFORM ANEURYSM of the basilar artery is a well-recognized clinical and pathological entity.

Fusiform aneurysm of the vertebrobasilar arterial system.

“…The other two patients may have bled from a concomitant carotid fusiform aneurysm since there is evidence that they are more prone to bleed than are vertebrobasilar fusiform aneurysms. 12 Nishizaki et al 5 studied 23 cases of vertebrobasilar fusiform aneurysm and divided the initial symptoms into ischemic and mass effects. Intracranial hemorrhage was described in only three patients, one of whom experienced a hypertensive cerebellar hemorrhage; the other two patients had saccular aneurysmal hemorrhages.…”

Ruptured Fusiform Aneurysm of the Proximal Anterior Cerebral Artery (A1 Segment) -Case Report-

“…33) Progression of atherosclerosis can lead from dilated and tortuous arteries to the formation of fusiform aneurysm. 11,14,16,23,24,29) Fusiform aneurysm develops from the parent artery irrespective of any bifurcation, forming a broad base, and both the parent artery and the aneurysm exhibit marked atherosclerosis. 16,17,25,29) In the present case, left internal carotid angiography revealed fusiform dilatation of the left A 1 segment indicating either fusiform or dissecting aneurysm.…”

“…11,14,16,23,24) Fusiform aneurysm developing in the ICA or MCA sometimes extends to the anterior cerebral artery (ACA), but fusiform aneurysm restricted to the ACA is very rare, 5,15,16,23,27,29) accounting for only about 1% of aneurysms arising from the ACA. 20) The incidence of proximal ACA (A 1 segment) aneurysms is reported to be 0.76-3.4%, often in cases of vascular anomalies complicated by aneurysms and cases of multiple aneurysms, and mostly of saccular type.…”

Ruptured Saccular Aneurysm of a Dolichoectatic Internal Carotid Artery in a Patient With Agenesis of the Contralateral Internal Carotid Artery-Case Report-

“…9,[13][14][15]22) Dolichoectasia occurs particularly often in the vertebrobasilar system. 6,9,18,22) Dolichoectasia is frequently associated with ischemia, 9,11,12) and can also progress to arterial rupture with subarachnoid hemorrhage via dissection of the arterial wall. 5,6,22) In our case, a saccular aneurysm had formed on the dolichoectatic ICA, and then ruptured to cause intraventricular hemorrhage with slight subarachnoid hemorrhage.…”