Microsurgical clipping for the true posterior communicating artery aneurysm in the distal portion of the posterior communicating artery

Abstract

Background:Aneurysms arising from the posterior communicating artery (PCoA) itself are rare in which aneurysms usually located in the proximal portion of the PCoA. The authors report a case of the true PCoA ruptured aneurysm in the distal portion of the PCoA.Case Description:The patient was an 83-year-old man who suffered subarachnoid hemorrhage. Cerebral angiography revealed a saccular aneurysm arising on the fetal type right PCoA itself in the distal portion of the PCoA. 2 days after the onset of symptoms, the patient underwent right interfascial pterional craniotomy, with anterior temporal approach. The aneurysm was successfully clipped with the preservation of both the PCoA and the thalamoperforating artery.Conclusion:We speculated that blood flow into the PCoA gradually increased after occlusion of the left vertebral artery, which induced tortuosity of the PCoA. As a result, hemodynamic stress might increase near the curvature and cause aneurysm formation.

<p>Traumatic Subarachnoid Hemorrhage Resulting from Posterior Communicating Artery Rupture</p>

“…Most PCoA aneurysms originate from the junction of internal carotid artery (ICA) with PCoA and few of them arise from PCoA itself. [14][15][16] Only 0.1%-2.8% of all intracranial aneurysm arises from PCoA itself like our cases. [14][15][16] And the size of our aneurysm was only 1.8 mm, which was not detectable on CT angiography.…”

Fusiform “True” Posterior Communicating Artery Aneurysm with Basilar Artery Occlusion: A Case Report

“…According to the literature, most cases report a combination of a fetal type PCoA and formation of a true PCoA aneurysm. 3 According to Munarriz et al, 4 hemodynamic stress plays an important role in the treatment of true PCoA aneurysms, as these aneurysms are often associated with a dominant PCoA (fetal type), wherein the PCoA is the major blood supply to the PCA and is associated with a higher flow through it. 4 Hence, preserving the PCoA is of utmost importance, even if it is hypoplastic.…”

Morphometric analysis of oculomotor triangle in dry human skulls and its clinical applications

“…By this medial triangle, the horizontal cavernous part of ICA could be seen for many vascular-related diseases and has significant association with vascular dilations (aneurysms) which forms the junction of posterior-communicating arteries. [ 5 ] The dural venous channels of the cavernous sinus at posterior-most aspect communicate with the posterior-most turn of cavernous portion of ICA along with the root of meningohypophyseal trunk, interclinoid ligament, and proximal intercavernous pathway of abducens nerve Cranial Nerve VI (CN VI). [ 6 ] Our research studies and information have caused good quality impact article publications from our team.…”