Ruptured intracranial aneurysm associated with isolated aortic arch interruption

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Vascular Neurology

Background:

• Interruption of the aortic arch (IAA) is a rare congenital cardiovascular anomaly characterized by discontinuity between the ascending and descending aorta.
• Survival into adulthood is uncommon, often facilitated by collateral arterial pathways ensuring blood supply to the descending aorta.
• Intracranial aneurysms are exceptionally rare in patients with IAA, with only one prior reported case.

Observation:

• This report details a 16-year-old male patient presenting with an isolated aortic arch interruption.
• The patient also exhibited a ruptured anterior communicating artery aneurysm, a highly unusual co-occurrence.
• The absence of other congenital defects suggests an isolated presentation of both conditions.

Findings:

• The case underscores the potential for rare cardiovascular malformations like isolated IAA to coexist with cerebrovascular pathologies such as anterior communicating artery aneurysms.
• The successful management of this complex presentation is critical for patient survival and neurological outcomes.
• This finding expands the known spectrum of vascular complications associated with aortic arch anomalies.

Implications:

• Highlights the importance of comprehensive vascular screening in patients diagnosed with rare congenital aortic defects.
• Suggests a potential, albeit rare, predisposition for aneurysm formation in patients with aortic arch interruption.
• Informs clinical management strategies for pediatric and adult patients with complex congenital heart disease and associated vascular risks.