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- Title
De novo giant A2 aneurysm following anterior communicating artery occlusion.
- Authors
Ibrahim, Tarik F.; Hafez, Ahmad; Andrade-Barazarte, Hugo; Raj, Rahul; Niemela, Mika; Lehto, Hanna; Numminen, Jussi; Jarvelainen, Juha; Hernesniemi, Juha
- Abstract
Background: De novo intracranial aneurysms are reported to occur with varying incidence after intracranial aneurysm treatment. They are purported to be observed, however, with increased incidence after Hunterian ligation; particularly in cases of carotid artery occlusion for giant or complex aneurysms deemed unclippable. Case Description: We report a case of rightsided de novo giant A2 aneurysm 6 years after an anterior communicating artery (ACoA) aneurysm clipping. We believe this de novo aneurysm developed in part due to patientspecific risk factors but also a significant change in cerebral hemodynamics. The ACoA became occluded after surgery that likely altered the cerebral hemodynamics and contributed to the de novo aneurysm. We believe this to be the first reported case of a giant de novo aneurysm in this location. Following parent vessel occlusion (mostly of the carotid artery), there are no reports of any de novo aneurysms in the pericallosal arteries let alone a giant one. The patient had a dominant right A1 and the sudden increase in A2 blood flow likely resulted in increased wall shear stress, particularly in the medial wall of the A2 where the aneurysm occurred 2 mm distal to the A12 junction. Conclusion: ACoA preservation is a key element of aneurysm surgery in this location. Suspected occlusion of this vessel may warrant closer radiographic followup in patients with other risk factors for aneurysm development.
- Subjects
ARTERIAL occlusions; BLOOD flow; ARTERIAL ligation; HEMODYNAMICS; THERAPEUTICS
- Publication
Surgical Neurology International, 2015, Vol 6, Issue Suppl 21, p1
- ISSN
2229-5097
- Publication type
Case Study
- DOI
10.4103/2152-7806.168074