Disappearance of Ruptured Posterior Cerebral Artery Aneurysm Associated with Internal Carotid Artery Occlusion After Superficial Temporal Artery-to-Middle Cerebral Artery Bypass
| Autor: | Yabo Huang, Zhong Wang, Qingdong Han, Peng Zhou |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Middle Cerebral Artery Subarachnoid hemorrhage Posterior cerebral artery Aneurysm Ruptured 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Aneurysm medicine.artery medicine Humans cardiovascular diseases medicine.diagnostic_test Cerebral Revascularization business.industry Intracranial Aneurysm Digital subtraction angiography Middle Aged medicine.disease Superficial temporal artery nervous system diseases Temporal Arteries Cerebrovascular Disorders Middle cerebral artery cardiovascular system Surgery Female Neurology (clinical) Radiology Internal carotid artery business 030217 neurology & neurosurgery Carotid Artery Internal Circle of Willis |
| Zdroj: | World neurosurgery. 116 |
| ISSN: | 1878-8769 |
| Popis: | Background Internal carotid artery (ICA) occlusion associated with posterior cerebral artery (PCA) aneurysms is regarded as a rare cerebrovascular disease. Common treatment of aneurysms—direct clipping or coiling—is not taken into consideration for this kind of cerebrovascular property. Combined surgical cerebrovascular reconstruction of the superficial temporal artery−to−middle cerebral artery (STA-MCA) bypass offers a chance to downregulate the hemodynamic stress of aneurysm rupture. Case Description A 46-year-old female presented with a fever and headache 1 month ago. An axial computed tomography scan showed a subarachnoid hemorrhage (SAH). Digital subtraction angiography (DSA) was conducted, and the patient received an STA-MCA bypass following medical treatment for 1 month in the local hospital. Computed tomography angiography and DSA demonstrated an aneurysm located on the right PCA and an occlusion of the right ICA in our hospital. Three days after admission, the right STA-MCA bypass was performed. The patient suffered no neurologic deterioration and lived a normal life. 6 months after the STA-MCA bypass, DSA of the right vertebral artery revealed disappearance of the aneurysm located on the right PCA (P2 segment). Conclusions Owing to ICA occlusion, the gap of hemodynamic stress between the posterior segment of the circle of Willis and anterior segment of the circle of Willis enlarged. This may lead to a ruptured PCA aneurysm. In this case, the aneurysm disappeared following an STA-MCA bypass. STA-MCA bypass may be one of the major reasons downregulating the gap, which can be regarded as an effective option concerning such aneurysms. |
| Databáze: | OpenAIRE |
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