Dissecting aneurysms involving both anterior cerebral artery and aorta

Abstract

Non-traumatic intracranial dissecting aneurysm (IDA) has been recently reported with increasing frequency and is recognized as a possible cause of subarachnoid hemorrhage. However, the pathogenesis of this disease is still unclear. Cystic medial necrosis (CMN) is known to be a cause of aortic dissection, especially in Marfan's syndrome. Presented herein is the case of a 49-year-old man who had IDA of the right anterior cerebral artery and abdominal aortic dissection without Marfan's syndrome. Histological examination showed medial degenerative changes with the accumulation of acid mucopolysaccharides in various intra- and extracranial arteries. Coexistence of dissecting aneurysms in the anterior cerebral artery and aorta suggests the presence of underlying pathogenesis that is common to these two dissection processes.

High prevalence of intracranial aneurysms in patients with aortic dissection or aneurysm: feasibility of extended aorta CT angiography with involvement of intracranial arteries

“…Thus it was 32% (8/25) in AD compared with 20.3% (27/133) in the AA group, and these patients had no comorbidity. In contrast to the AA group, there were few case reports of concurrent IAs in patients with ADs, all of which were associated with Marfan's syndrome 16 17. Some authors reported that the prevalence of IAs in patients with coarctation of the aorta was >10% 18 19.…”

Prevalence of Intracranial Aneurysms in Patients with Aortic Dissection

“…Recently, some authors [5][6][7] have published the link between IA and aortic aneurysm, which showed an IA incidence of 9%-11% in patients with aortic aneurysms. However, there are a limited number of genetic or experimental studies [8][9][10] and case reports [11][12][13] for the association between IA and aortic dissection (AD).…”

Anterior cerebral artery aneurysm associated with multiple intracranial aneurysms and abdominal aorta aneurysm

“…In this case, the aneurysms were observed in the abdominal aorta as well as in the intracranial arteries on the A3 segment of the ACA and at the bifurcation of the MCA. A previous report [10] suggested that coexistence of dissecting aneurysms in the ACA and abdominal aorta was related to the pathological findings of medial degenerative changes with the accumulation of acid mucopolysaccharides. IAs and AAA, however, result from different underlying disease processes, and thus have different risk factors [2].…”