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Fusiform aneurysm of a persistent trigeminal artery
D Agrawal1, A K Mahapatra, N K Mishra
1Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Summary
Endovascular coiling of a persistent trigeminal artery fusiform aneurysm is feasible but carries risks. Delayed stroke occurred due to vasospasm, highlighting the need for careful management of these rare vascular lesions.
Area of Science:
- Neurology
- Vascular Surgery
- Interventional Radiology
Background:
- Persistent trigeminal artery (PTA) aneurysms are exceptionally rare.
- Endovascular treatment for PTA fusiform aneurysms has not been previously documented.
Observation:
- A 50-year-old patient with a PTA fusiform aneurysm presented with headache and neck stiffness.
- Cerebral angiography confirmed the aneurysm and identified adult-type posterior cerebral arteries.
Findings:
- Endovascular occlusion of the PTA was performed using Guglielmi detachable coils (GDCs).
- The procedure was tolerated, but delayed ischemic neurological deficits developed, attributed to vasospasm.
Implications:
- Endovascular occlusion of PTA, even with independent circulation, risks posterior circulation stroke via perforator occlusion or vasospasm.
- Optimal timing for endovascular intervention after PTA aneurysm rupture requires further definition.