Hemodynamic Impact of a Spontaneous Cervical Dissection on an Ipsilateral Saccular Aneurysm
Journal of Cerebrovascular and Endovascular Neurosurgery
; : 110-114, 2016.
Article
en En
| WPRIM
| ID: wpr-144502
Biblioteca responsable:
WPRO
ABSTRACT
The dynamic, hemodynamic impact of a cervical dissection on an ipsilateral, intracranial saccular aneurysm has not been well illustrated. This 45-year-old female was found to have a small, supraclinoid aneurysm ipsilateral to a spontaneous cervical internal carotid artery dissection. With healing of the dissection, the aneurysm appeared to have significantly enlarged. Retrospective review of the magnetic resonance imaging (MRI) at the time of the initial dissection demonstrated thrombus, similar in overall morphology to the angiographic appearance of the "enlarged" aneurysm. As the dissection healed far proximal to the intradural portion of the internal carotid artery, this suggested that the aneurysm was likely a typical, saccular posterior communicating artery aneurysm that had thrombosed and then recanalized secondary to flow changes from the dissection. The aneurysm was coiled uneventfully, in distinction from more complex treatment approaches such as flow diversion or proximal occlusion to treat an enlarging, dissecting pseudoaneurysm. This case illustrates that flow changes from cervical dissections may result in thrombosis of downstream saccular aneurysms. With healing, these aneurysms may recanalize and be misidentified as enlarging dissecting pseudoaneurysms. Review of an MRI from the time of the dissection facilitated the conclusion that the aneurysm was a saccular posterior communicating artery aneurysm, influencing treatment approach.
Palabras clave
Texto completo:
1
Índice:
WPRIM
Asunto principal:
Trombosis
/
Imagen por Resonancia Magnética
/
Arteria Carótida Interna
/
Aneurisma Intracraneal
/
Estudios Retrospectivos
/
Aneurisma Falso
/
Disección de la Arteria Carótida Interna
/
Hemodinámica
/
Aneurisma
Tipo de estudio:
Observational_studies
Límite:
Female
/
Humans
Idioma:
En
Revista:
Journal of Cerebrovascular and Endovascular Neurosurgery
Año:
2016
Tipo del documento:
Article