Giant unruptured anterior communicating artery aneurysm presenting with seizure

Çağavi, Ferda; Kalaycı, Murat; Ünal, Aysun; Atasoy, H. Tuğrul; Çağavi, Zeynep; Açıkgöz, Bektaş

doi:10.1016/j.jocn.2005.04.024

Cited by 12 publications

(7 citation statements)

References 24 publications

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“…Several mechanisms have been postulated to explain the seizures caused by unruptured intracranial aneurysm that can be transposed for the MMA. [ 3 8 10 11 16 ] It is explained in our case by the irritation of the temporal cortex by the aneurysm. Drug resistance may indicate the evolutionary character of the aneurysm or a prerupture phase.…”

Section: Discussionmentioning

confidence: 70%

Middle meningeal artery aneurysm: Case report

Kpelao¹,

Békéti²,

Ahanogbe³

et al. 2017

Surg Neurol Int

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Background:Aneurysms of meningeal middle artery (MMA) are extremely rare. These aneurysms are of two types: true aneurysm and pseudoaneurysm. The true type is usually seen with pathologic conditions. Pseudoaneurysms, on the other hand, are associated with a skull fracture. Epilepsy caused by MMA aneurysm has never been described to our knowledge. We report a case of true aneurysm isolated from MMA revealed by epilepsy.Case Description:A 57-year-old patient with a history of high blood pressure developed epilepsy which was treated by valproic acid. Initial scalp electroencephalography (EEG) showed seizure activity arising from the right temporal area. Epilepsy had become drug-resistant. Cerebral angiography revealed an aneurysm of the right middle meningeal artery without any other intraparenchymal anomaly. The interrogation did not reveal any history of family aneurysm. The patient underwent surgery with coagulation of the aneurysm and the MMA. The aneurysm was intradural in contact with the temporal cortex, and the surrounding brain tissues were preserved. The operative follow-up was favorable with amelioration of convulsions with a single antiepileptic. We planned to stop antiepileptic treatment according to electroencephalograms.Conclusions:Aneurysms of the MMA are rare. Their mode of revelation by seizures is unusual. The factors of rupture are not known. When isolated, their physiopathology is identical to that of the aneurysms of the Willis polygon. Their management uses the same techniques as for other cerebral aneurysms.

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Section: Discussionmentioning

confidence: 70%

Middle meningeal artery aneurysm: Case report

Kpelao¹,

Békéti²,

Ahanogbe³

et al. 2017

Surg Neurol Int

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“…However, it should be remembered that rarely unruptured intracranial aneurysms can cause other neurologic and neuropsychiatric symptoms and/or disorders. Other previously described unusual presentations of unruptured intracranial aneurysms include migraine without aura,[ 13 ] focal and generalized seizures,[ 4 9 ] frontal lobe syndrome,[ 1 ] and sudden vision loss[ 11 ] [ Table 1 ]. Treatment of an underlying aneurysm can alleviate these symptoms and improve patient's health status.…”

Section: Discussionmentioning

confidence: 99%

Unruptured anterior communicating artery aneurysm presenting as depression: A case report and review of literature

et al. 2016

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Background:Intracranial aneurysms most commonly present following rupture causing subarachnoid hemorrhage. Mental disorders are common among patients with unruptured intracranial aneurysms and in aneurysmal subarachnoid hemorrhage survivors. However, to the best of our knowledge, there is no published report of unruptured intracranial aneurysm presenting as a mental disorder.Case Description:A 69-year-old male without a past history of mental disorders and neurological symptoms presented with a 2-month history of anxiety, sadness, lack of pleasure in usual activities, fatigue, difficulties falling asleep and waking up early in the morning, reduced appetite, and weight loss. The patient was diagnosed with major depressive disorder and antidepressant treatment was initiated. Subsequent non-contrast computed tomography (CT) of the head demonstrated hypointense oval-shaped lesion within the projection of the anterior communicating artery. CT angiography confirmed the diagnosis of a 0.8 × 0.6 cm saccular aneurysm originating from the anterior communicating artery and anterior cerebral artery. The patient underwent microsurgical clipping of the aneurysm. On psychiatric assessment 1 month after the surgery, there were no signs of depressive disorder and antidepressive treatment was discontinued. On follow-up visit 1 year after the surgery, the patient did not have any mood symptoms.Conclusions:The case indicates that organic brain lesions, including intracranial aneurysms, should be suspected in elderly patients presenting with their first episode of mental disorder.

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“…Jamais un mode de révélation par une cécité bilatérale n'a été décrit [1, 2]. Les anévrysmes intracrâniens (AIC) rompus sont de loin la cause la plus fréquente des hémorragies méningées non traumatiques, c'est une urgence neurologique avec des conséquences potentiellement dévastatrices [3].…”

Section: Discussionunclassified

Tableau de cécité bilatérale à fond d’œil normal révélant un anévrisme non rompu de l’artère cérébrale communicante antérieure

et al. 2014

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Les anévrysmes intracrâniens non rompu (AICNR) se manifestent le plus souvent par des tableaux cliniques non spécifiques (céphalées, accidents vasculaires ischémiques cérébraux, paralysies des nerfs crâniens) et sont généralement découverts à l'occasion d'imagerie cérébrale pour d'autres raisons. Une cécité bilatérale révélant AICNR de l'artère communicante antérieure est unique dans la littérature. Il s'agit d'un homme de 48 ans sans antécédents médicaux notables qui consulte aux urgences ophtalmologiques pour baisse de l'acuité visuelle rapidement évolutive en une semaine aboutissant à une cécité bilatérale. L'examen ophtalmologique objective une acuité visuelle réduite à la présence d'une perception lumineuse bilatérale avec un bon réflexe photomoteur et le reste de l'examen ophtalmologique qui est strictement normal. Un examen général réalisé en urgence trouve une tension artérielle à 20/14mmHG. L'imagerie cérébrale notamment une tomodensitométrie cérébrale complétée par une imagerie en résonnance magnétique objective un aspect spectaculaire d'un grand anévrisme de l'artère cérébrale communicante antérieure partiellement thrombosé responsable d'une compression isolée du chiasma optique. Après un équilibre de l'hypertension artérielle le patient a été adressé en neurochirurgie pour une thérapeutique en urgence. Un anévrisme est toujours la conséquence d'une modification structurale de la paroi artérielle. Dans leur forme commune, les anévrismes développés sur les artères intracrâniennes sont sacciformes. Ses étiologies sont nombreuses et variées. L’évolution des anévrysmes intracrâniens se fait vers une augmentation de leur volume sous l'influence de facteurs hémodynamiques qui conduit à une fragilisation de leur paroi. Une rupture de l'anévrisme est le mode de découverte le plus fréquent et aussi le plus dramatique. Toute baisse d'acuité visuelle à fond d'oeil normal doit imposer sans retard une imagerie orbito-cérébrale.

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Giant unruptured anterior communicating artery aneurysm presenting with seizure

Cited by 12 publications

References 24 publications

Middle meningeal artery aneurysm: Case report

Middle meningeal artery aneurysm: Case report

Unruptured anterior communicating artery aneurysm presenting as depression: A case report and review of literature

Tableau de cécité bilatérale à fond d’œil normal révélant un anévrisme non rompu de l’artère cérébrale communicante antérieure

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