Ruptured distal anterior choroidal artery aneurysm presenting as isolated intraventricular hemorrhage: Case report and comprehensive review of the literature

Tan, Chi Hau; Lai, Leon T.; Chandra, Ronil V.

doi:10.4103/ajns.ajns_256_16

Cited by 4 publications

(2 citation statements)

References 27 publications

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“…Distal MCA aneurysms originate along the main trunk of each segment, and the M2 segment is the most commonly affected. 1) On the other hand, several reports describing aneurysms originating from small perforating or penetrating branches, such as lenticulostriate artery (LSA), 7) anterior choroidal, 8 , 9) thalamostriate, 10) and distal basilar arteries, 11) have been published. As for a penetrating artery of the distal MCA, aneurysms originating from this artery are rare.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Management of Ruptured Aneurysms Originating from the Penetrating Artery of the Distal Middle Cerebral Artery

Iida

Mori

Kawahara

et al. 2021

NMC Case Report Journal

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We report a rare case of an aneurysm originating from the penetrating artery of the distal middle cerebral artery (MCA). A 76-year-old man without a notable past history presented with sudden-onset severe headache, left hemiparesis, and a decreased level of consciousness. Computed tomography (CT) revealed subarachnoid hemorrhage (SAH) with intracerebral hemorrhage (ICH) in the right temporal lobe extending into the ventricle. Contrast-enhanced CT (CE-CT) demonstrated a focus of contrast enhancement (CE) adjacent to the hematoma in the right frontal lobe. An aneurysm fed by a penetrating artery branching off from the right distal MCA was found on angiography. The patient underwent emergency resection of the aneurysm and hematoma evacuation. Histological analysis revealed that arterial dissection may be an associated factor in the pathogenesis of this peripheral aneurysm formation. A focus of CE within or adjacent to the hematoma may be useful for diagnosing this peripheral aneurysm. ICH can result in a life-threatening situation. Therefore, microsurgery may be the first treatment choice for aneurysms in this location.

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Section: Discussionmentioning

confidence: 99%

Characteristics and Management of Ruptured Aneurysms Originating from the Penetrating Artery of the Distal Middle Cerebral Artery

Iida

Mori

Kawahara

et al. 2021

NMC Case Report Journal

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“…Endovascular embolization and microsurgical clamping or resection can achieve the above purpose. [7] We describe an apathetic male patient with MMD who found an aneurysm in the distal anterior choroidal artery (AchA) and successfully resected the aneurysm after craniotomy with remarkable results.…”

Section: Introductionmentioning

confidence: 99%

Moyamoya disease with distal anterior choroidal artery aneurysm resected via transcallosal approach: A case report and review

et al. 2023

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Rationale: Moyamoya disease (MMD) is a cerebrovascular structural disorder characterized by bilateral stenosis and obstruction of the internal carotid artery, anterior cerebral artery, and initial segment of a middle cerebral artery, as well as the aberrant formation of collateral arteries at the base of the brain. Moyamoya disease with distal anterior choroidal artery (AChA) aneurysm is extremely uncommon. At present, the treatment of Moyamoya disease with aneurysm mainly includes conservative treatment and surgical treatment, including revascularization, endovascular therapy and microsurgical clipping or resection. Interventional therapy is the first treatment of choice. For those whose paths are tortuous and inaccessible and intervention fails, I successfully excised them through craniotomy. Patient concerns: The 38-year-old male patient, diagnosed with Moyamoya disease 11 years ago and was hospitalized for multiple intraventricular hemorrhages throughout that time. During the 11 years, the patient was hospitalized for intra ventricular hemorrhage for several times. The patient was diagnosed as moyamoya disease for many times by digital subtraction angiography, but he was recommended to come to our hospital for cerebrovascular bypass surgery 3 months after each hemorrhage, but he did not come to our hospital until the next intraventricular hemorrhages. Diagnoses: This recurrent intraventricular bleeding was suspected to be caused by MMD, and a digital subtraction angiography of the brain revealed an aneurysm of the distal AChA. Interventions: Interventional therapy was the first choice. During the operation, transcatheter aneurysm embolization was tried. Finally, interventional therapy was abandoned because the vessels were too thin and tortuous and the guide wire could not pass through. After detecting the aneurysm using computerized tomography angiography, the distal AChA aneurysm was resected through the lateral interventricular foramen of the corpus callosum, and the corpus callosum was parted along the interhemispheric fissure to access the third ventricle. Outcomes: On the 21st postoperative day, the patient improved, recovered to a Glasgow Coma Scale score of 15. Lessons: We conclude that craniotomy is a satisfying alternative in patients with MMD complicated by perforated distal AChA aneurysm hemorrhage if the vascular prerequisites for endovascular treatment are not accessible and the patient has a favorable prognosis.

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Management of a ruptured intraventricular aneurysm arising from distal anterior choroidal artery (AChA): pediatric case report

et al. 2020

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Ruptured distal anterior choroidal artery aneurysm presenting as isolated intraventricular hemorrhage: Case report and comprehensive review of the literature

Cited by 4 publications

References 27 publications

Characteristics and Management of Ruptured Aneurysms Originating from the Penetrating Artery of the Distal Middle Cerebral Artery

Characteristics and Management of Ruptured Aneurysms Originating from the Penetrating Artery of the Distal Middle Cerebral Artery

Moyamoya disease with distal anterior choroidal artery aneurysm resected via transcallosal approach: A case report and review

Management of a ruptured intraventricular aneurysm arising from distal anterior choroidal artery (AChA): pediatric case report

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