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

Abstract

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.

Prognostic factors influencing outcome in unruptured anterior communicating artery aneurysm after microsurgical clipping

“…Anterior communicating artery (A.com.A) aneurysms are among the most common aneurysms in different case series. [ 1 ] They comprise 20.6% in our latest case series of unruptured aneurysms coming 2 nd only to middle cerebral artery (MCA) aneurysm. Unruptured intracranial aneurysms are diagnosed with greater frequency as imaging techniques improve.…”

Depression and depression-related disorders after a subarachnoid hemorrhage

“…Например, аневризмы передней соединительной артерии (ПСоА) могут приводить к развитию нарушений памяти (по типу корсаковского синдрома), конфабуляций и изменений личности (так называемый синдром ПСоА) [12]. В литературе [13] имеется описание развития депрессии de novo у пациентки 69 лет с неразорвавшейся аневризмой ПСоА, без психических нарушений в анамнезе. Депрессия полностью разрешилась после клипирования аневризмы.…”