Document Detail


Internal carotid artery dorsal wall aneurysm with configurational change: Are they all false aneurysms?
MedLine Citation:
PMID:  17015137     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Aneurysms arising from nonbranching sites of the ICA, so-called dorsal wall aneurysm, are rare entity, and present as blister type or saccular type. Occasionally configurational changes have been observed on serial cerebral angiography: a small blister-like bulge on ICA wall on initial angiography progressing to a saccular appearance within a few weeks. Such aneurysm showing configurational change has been regarded as a false aneurysm with fragile wall just like blister-type aneurysm, and direct surgical approach has been considered highly risky. CASE DESCRIPTION: A 42-year-old woman with a subarachnoid hemorrhage revealed small "blister-like" aneurysm at the medial wall of the ICA on initial angiography. After 12 days, the following angiograms demonstrated increased aneurysmal size and change of shape into a saccular configuration. Direct surgical approach was performed. The aneurysm had a relatively firm neck, and was successfully clipped without intraoperative rupture. The dome of aneurysm was resected after clipping and the histologic examination revealed it as a true aneurysm. CONCLUSIONS: This case suggests that all dorsal wall aneurysms with configurational change are not false aneurysms, and that angiographic findings do not always correlate with the nature of the aneurysmal wall; therefore, we should give more credence to direct surgical observation rather than preoperative angiographic findings when considering the most suitable surgical option.
Authors:
Jong-Hyun Kim; Taek-Hyun Kwon; Joo-Han Kim; Youn-Kwan Park; Hung-Seob Chung
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2006-07-21
Journal Detail:
Title:  Surgical neurology     Volume:  66     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-10-03     Completed Date:  2006-11-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  441-3; discussion 443     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, College of Medicine, Korea University, Seoul 152-703, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aneurysm, False / pathology*,  physiopathology,  radiography
Carotid Artery, Internal / pathology*,  physiopathology,  radiography
Carotid Artery, Internal, Dissection / pathology*,  physiopathology,  radiography
Cerebral Angiography
Diagnosis, Differential
Disease Progression
Female
Humans
Intracranial Aneurysm / pathology*,  physiopathology,  radiography
Neurosurgical Procedures
Predictive Value of Tests
Subarachnoid Hemorrhage / pathology,  physiopathology,  radiography
Surgical Instruments
Treatment Outcome
Vascular Surgical Procedures

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


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