Intracranial Serpentine Aneurysms: Spontaneous Changes of Angiographic Filling Pattern

Kandemirli, Sedat Giray; Çekirge, Saruhan; Oran, İsmail; Saatçi, Işıl; Kızılkılıç, Osman; Çınar, Celal; Işlak, Civan; Koçer, Naci

doi:10.3174/ajnr.a5746

Cited by 13 publications

(16 citation statements)

References 28 publications

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“…In the former, there is increased risk of platelet aggregation and thrombus formation with consequent tissue ischemia, in the latter instead the higher jet flow predisposes to collateral vascular bed formation. The Coanda effect has been previously proposed and demonstrated in the pathogenesis of arterial thrombus formation as well as in other neurovascular anomalies as arterial serpentine aneurysms in humans and may also play a role in the presented dog (15,16).…”

Section: Discussionmentioning

confidence: 91%

Striate Artery Infarct After Bilateral Carotid Artery Ligation (BCAL) in a Dog: A Multimodal MRI Study

et al. 2020

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Bilateral carotid artery ligation has been reported as a lifesaving procedure to control severe hemorrhage. However, reports are sparse and little information is available regarding the potential risks associated with this procedure. We report an ischemic brain infarct as a complication after vascular surgery. A 3-year old, male intact border collie was presented for acute onset of forebrain signs 5 days after bilateral carotid artery ligation. Multimodal brain MRI including morphologic sequences, MR angiography, diffusion-and perfusion-weighted images were performed. MRI revealed a well-defined intra-axial lesion of the left caudate nucleus, with increased T2 and decreased T1 signal intensity and moderate heterogeneous peripheral contrast enhancement. The cerebral blood flow was reduced relative to the contralateral caudate nucleus. Images were consistent with a subacute lacunar ischemic infarct of the left striate artery. Additionally, multiple arterio-arterial anastomosis arising from the vertebral arteries were visible in the angiography sequences. Ischemic infarct due to thromboembolism should be considered as a possible complication associated with bilateral carotid artery ligation. Collateral blood supply can develop as early as 5 days after surgery.

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Section: Discussionmentioning

confidence: 91%

Striate Artery Infarct After Bilateral Carotid Artery Ligation (BCAL) in a Dog: A Multimodal MRI Study

et al. 2020

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“…GSA usually exhibits progressive mass effects due to its 1–4-mm-thick fibrous wall and peripheral calcified thrombus (midline shift and perifocal brain tissue edema on CT scan). Nevertheless, subarachnoid hemorrhage is not regarded as a common presentation of GSAs [ 4 ]. Thus, GSA progression can be characterized by progressive mass effects, rupture bleeding, and spontaneous occlusion.…”

Section: Discussionmentioning

confidence: 99%

Giant serpentine aneurysm of the internal cerebral artery and mandibular aneurysm: a case report

Deng

Feng

2019

Chin Neurosurg Jl

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Background: Giant serpentine aneurysms (GSA) originate from saccular or spindle aneurysm, dissimilar from dissected aneurysm, that are defined as partially thrombosed giant aneurysms with tortuous internal vascular channel. The clinical and neuroradiologic characteristics are clarified and the mechanism of formation and the efficacy of double stent implantation in GSA are discussed. Case presentation: An 18-year-old man presented himself with a GSA arising from the internal cerebral artery (ICA). In addition, a mandibular aneurysm (MA) arose from the external cerebral artery (ECA). Success was achieved in treating GSA through endovascular treatment with double stents implanted in the parent artery, which were LEO stent and Tubridge flow diverter. After 1 year of follow-up, three-dimensional reconstruction of blood vessels revealed the disappearance of the serpentine access of GSA, which was found to be replaced with a roughly normal vascular structure. Conclusions: Double stent implantation has provided a feasible treatment option for giant serpentine internal carotid aneurysms and eliminated the possibility of causing collateral circulation occlusion. Therefore, it represents a simple and suitable treatment method for anatomical structure and operation.

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“…After this publication, we found 46 more aneurysms (46 patients), including the Kandemirli et al 9) series. We included an article written in Japanese 19) (1 patient with 2 aneurysms) with an English abstract, ignored by Kandemirli et al 9) Thus, the literature has 147 patients with 149 GSAs (Table 1). These aneurysms were most frequently located in MCA (65/149, 43.6%) Conservative treatment was preferred 6 patients (4.1%), one of which was in locked-in syndrome, and 5 (3.4%) patients accepted as inoperable died.…”

Section: Literature Reviewmentioning

confidence: 95%

“…The most comprehensive literature review was published by Kandemirli et al 9) in 2018 and found 100 patients with 101 aneurysms. After this publication, we found 46 more aneurysms (46 patients), including the Kandemirli et al 9) series. We included an article written in Japanese 19) (1 patient with 2 aneurysms) with an English abstract, ignored by Kandemirli et al 9) Thus, the literature has 147 patients with 149 GSAs (Table 1).…”

Section: Literature Reviewmentioning

confidence: 99%

Endovascular occlusion of giant serpentine aneurysm: A case report and literature review

Civlan

Yakar

Çoşkun

et al. 2022

J Cerebrovasc Endovasc Neurosurg

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Giant serpentine aneurysms (GSAs) are a rare subgroup of intracranial aneurysms. Separate inflow and outflow flow due to intraluminal thrombosis is the most distinguishing feature of GSAs. In treating these lesions, surgical clipping and ligation were the main treatments in the past, but bypass for revascularisation and endovascular therapies (EVTs) for deconstructive purposes are more prominent today. A 51-years-old male patient presented with headache and mild right hemiparesis. He had a GSA arising from the left fetal type posterior cerebral artery (fPCA) that was out of follow-up for six years. Radiological images revealed midline shifting and mesencephalon compression. We performed endovascular parent artery coil occlusion. The symptoms of the patient improved at the first-month follow-up. Even if there is a mass effect in GSAs, deconstructive EVT is a safe and feasible method for managing these lesions.

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Intracranial Serpentine Aneurysms: Spontaneous Changes of Angiographic Filling Pattern

Cited by 13 publications

References 28 publications

Striate Artery Infarct After Bilateral Carotid Artery Ligation (BCAL) in a Dog: A Multimodal MRI Study

Striate Artery Infarct After Bilateral Carotid Artery Ligation (BCAL) in a Dog: A Multimodal MRI Study

Giant serpentine aneurysm of the internal cerebral artery and mandibular aneurysm: a case report

Endovascular occlusion of giant serpentine aneurysm: A case report and literature review

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