Unruptured intracranial aneurysm presenting with epiletic seizure

Abstract

-Intracranial aneurysms are frequently present with subarachnoid hemorrhage.Less often they produce suggestive symptoms of cranial nerve dysfunction or intracranial tumor when very large. Their association with epilepsy has rarely been reported; such concurrence may not be a coincidence. When the patient presents with epileptiforme attacks the presence of an intracranial aneurysm is rarely considered. In this paper we report the case of a 45-years-old patient with an unruptured aneurysm of the middle cerebral artery with a 10 years history of epileptic seizure.KEY WORDS: intracranial aneurysm, epilepsy, middle cerebral artery, giant aneurysm. Epilepsia secundária a aneurisma cerebral não rotoRESUMO -Aneurismas intracranianos freqüentemente se apresentam com hemorragia subaracnóidea quando rotos, porém quando gigantes sangram com menor freqüência e se comportam como verdadeiros tumores, comprimindo estruturas cerebrais adjacentes, apresentando sintomatologia peculiar. Relatamos o caso de um paciente de 45 anos que apresentava crises convulsivas generalizadas com evolução de 10 anos. A investigação radiológica revelou presença de aneurisma gigante da artéria cerebral média, não roto. É realizada revisão da literatura correlacionando a presença de aneurismas não rotos e epilepsia, pois esta associação é pouco freqüente na literatura. PALAVRAS-CHAVE: aneurisma intracraniano, epilepsia, artéria cerebral média, aneurisma gigante.

Frontal lobe neuropathology presenting to Mental Health Services

“…Unruptured intracranial aneurysms are usually not associated with seizures. However, there have been reports of seizures associated with right middle cerebral artery aneurysms as in Mrs C [11]. It is doubtful whether the intracranial aneurysm in Mrs C was directly related to her clinical presentation.…”

Giant unruptured anterior communicating artery aneurysm presenting with seizure

“…16 In all cases, the aneurysms were located on the middle cerebral artery. 18 Giant AComA aneurysms have been reported to present with subarachnoid haemorrhage, 19 visual loss, 19-23 bitemporal hemianopsia, 24 dementia, 19 anosmia, 25 headache, 22,23,26,27 frontal lobe psychotic syndrome, 28 loss of consciousness, 20,22 progressive neurological deficits, 29 aphasia 30 and blindness. 18 Giant AComA aneurysms have been reported to present with subarachnoid haemorrhage, 19 visual loss, 19-23 bitemporal hemianopsia, 24 dementia, 19 anosmia, 25 headache, 22,23,26,27 frontal lobe psychotic syndrome, 28 loss of consciousness, 20,22 progressive neurological deficits, 29 aphasia 30 and blindness.…”

Focal drug-resistant temporal lobe epilepsy associated with an ipsilateral anterior choroidal artery aneurysm: illustrative case

“…The overall incidence of ipsilateral intracranial aneurysms associated with DRE is unknown, and to our knowledge, only 12 cases of intracranial aneurysms together with medically refractory epilepsy across 7 institutions have been reported. 8,11,[14][15][16][17][18] Most of these cases describe temporal lobe epilepsies and focal seizures with impaired awareness associated with middle cerebral artery or, in fewer instances, posterior cerebral artery (PCA) aneurysms, which often resolved following surgical ligation of the offending aneurysm. All but 2 cases report on adult patients, underscoring the paucity of literature on this entity in pediatric patients.…”