Document Detail

Evolution from an infundibulum of the posterior communicating artery to a saccular aneurysm.
MedLine Citation:
PMID:  21140127     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: An infrequent case of a de novo aneurysm formation originating from an infundibulum at the origin of the posterior communicating artery (PcomA) is presented. The aneurysm developed within 7 years in a patient who initially presented with subarachnoid hemorrhage (SAH) from a saccular aneurysm of the vertebral artery.
CASE SUMMARY: A 43-year-old female patient was admitted to our hospital on 16th June 2000 after an acute onset of massive occipital headache. A computed tomography (CT) scan showed a subarachnoid hemorrhage (SAH) around the brainstem and 4-vessel angiography revealed an aneurysm originating from the V4 segment of the right vertebral artery (VA) as the cause of the SAH. A small aneurysm at the basilar artery (BA)/superior cerebellar artery (SCA) bifurcation was also found. Injection of the left internal carotid artery (ICA) showed a diffuse enlargement at the origin of the left PcomA, which at this time was considered to be a so-called infundibulum. The VA aneurysm was treated by coil occlusion. Follow-up digital subtraction angiography (DSA) in 2005 showed a de novo aneurysm formation at the VA junction, again treated by coil occlusion. The PcomA infundibulum at the left ICA was not examined. Follow-up angiography performed in 2007 revealed a saccular de novo aneurysm of the left ICA arising from the origin of the left PcomA with a maximum diameter of 12 mm. Coil occlusion of the PcomA aneurysm was subsequently carried out.
CONCLUSION: Infundibular widening of cerebral arteries can develop into true aneurysms. Mid-term and long-term follow-up MRI (e.g., in yearly intervals) is advised for infundibula with a diameter of 3 mm or more. In patients with other aneurysm(s), with a documented de novo aneurysm formation or with a familial occurrence of aneurysms, the risk of evolution of an infundibulum to a saccular aneurysm may be increased and follow-up should be even more stringent.
S Fischer; N Hopf; H Henkes
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Publication Detail:
Type:  Case Reports; Letter     Date:  2010-12-08
Journal Detail:
Title:  Clinical neuroradiology     Volume:  21     ISSN:  1869-1447     ISO Abbreviation:  Clin Neuroradiol     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-07-28     Completed Date:  2012-01-27     Revised Date:  2012-10-17    
Medline Journal Info:
Nlm Unique ID:  101526693     Medline TA:  Clin Neuroradiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  87-90     Citation Subset:  IM    
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MeSH Terms
Angiography, Digital Subtraction
Carotid Artery Diseases / diagnosis,  therapy
Carotid Artery, Internal
Cerebral Angiography
Disease Progression
Embolization, Therapeutic
Follow-Up Studies
Image Processing, Computer-Assisted
Imaging, Three-Dimensional
Intracranial Aneurysm / diagnosis*,  therapy
Subarachnoid Hemorrhage / diagnosis,  therapy
Tomography, X-Ray Computed
Vertebral Artery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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