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Basilar artery aneurysm with autonomic features: an interesting pathophysiological problem.
1Headache Group, Institute of Neurology, Queen Square, London WC1N 3BG, UK.
Journal of Neurology, Neurosurgery, and Psychiatry
|November 28, 2001
Summary
Posterior circulation aneurysms can cause rare ocular autonomic symptoms. Treating a basilar artery aneurysm with angiographic coiling led to symptom resolution, suggesting a causal link.
Area of Science:
- Neurology
- Ophthalmology
- Vascular Surgery
Background:
- Unruptured cerebral aneurysms commonly cause neuro-ophthalmological symptoms.
- Ocular autonomic dysfunction is an under-recognized presentation of posterior circulation aneurysms.
Observation:
- A patient presented with headache and unilateral autonomic symptoms attributed to a basilar artery aneurysm.
- Symptoms included ocular autonomic features not previously reported in posterior circulation aneurysm cases.
Findings:
- Angiographic coiling of the basilar artery aneurysm resulted in near-complete resolution of the patient's headache and autonomic symptoms.
- This suggests a direct pathophysiological link between the aneurysm and the trigeminal-autonomic cephalgia.
Implications:
- This case highlights a novel presentation of posterior circulation aneurysms.
- Understanding this mechanism may inform the diagnosis and management of secondary trigeminal-autonomic cephalgias.