The Pathology of Intracranial Arterial Aneurysms and Their Complications

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

“…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. A nationwide study of nontraumatic intracranial dissecting aneurysm in Japan found that the diagnostic criteria are vascular narrowing (tapered narrowing, string sign), vascular occlusion, aneurysmal outpouching, intimal flap, retention of contrast media in false lumen, etc.…”

“…Progressive expansion of fusiform aneurysm sometimes results in saccular or spherical shape, which is likely to result in hemorrhage and requires careful treatment. 25,29) Surgical treatment is required for fusiform aneurysm causing SAH or neurological symptoms. However, the management strategy of this type of aneurysm remains controversial.…”

Letter to the Editor: Internal carotid artery anterior wall aneurysms

“…Generally speaking, chronic hydrocephalus occurs in more than 20% patients after aneurysmal SAH 6 and accounts for nearly 35% of all shunts placed. 8 In a recent meta-analysis, 4 the rate of shunt-dependent hydrocephalus in all patients (treated with clip ligation or endovascular coil embolization) was reported to be 18.4%.…”

“…Unlike the theory introduced by Indo and colleagues, the anterior wall aneurysm could be more plausibly attributed to the previously reported mechanisms, such as arteriosclerosis, hemodynamic effects, or an abrupt bend of the ICA. [4][5][6] In conclusion, regardless of its drawbacks, the study by Dr. Indo and colleagues 2 contributed a great deal to the understanding of the pathogenesis of the ICA anterior wall aneurysm. We believe that this paper will definitely be among the influential reports on the subject of BBAs (Fig.…”

“…Graph depicting the increasing number of BBA publications and their cases in the following years. Subjectively selected papers explaining an anterior wall/BBA pathogenesis: 1) arteriosclerosis; 6 2) ulceration causes focal wall defect; 1 3) arterial hypertension; 4 4) ICA abrupt bending, sheer stress; 5 and 5) anomalous origin of OA.…”