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Published on: December 16, 2021
Ruptured aneurysm at the perforating artery supplying the insula: case report
Servet Inci1, Atila Akbay, Burcu Hazer
1Department of Neurosurgery, School of Medicine, Hacettepe University, Ankara, Turkey. servet@mailcity.com
Neurosurgery
|July 4, 2009
Summary
Ruptured aneurysms of perforating arteries are rare, often presenting as atypical intracerebral hematomas in younger patients. This case highlights a unique instance of a perforating artery aneurysm within the limen insulae.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Neuroradiology
Background:
- Perforating artery aneurysms (PAAs) are uncommon cerebrovascular lesions.
- Most PAAs arise from lenticulostriate arteries within the basal ganglia.
- Aneurysms originating from perforating branches of the middle cerebral artery (MCA) are exceptionally rare.
Observation:
- A 41-year-old male presented with an insular hematoma.
- The hematoma was attributed to a ruptured PAA on a proximal MCA branch supplying the insula.
- Radiological imaging revealed the aneurysm was uniquely embedded within the limen insulae, lacking subarachnoid hemorrhage.
Findings:
- Surgical resection of the rare PAA was successfully performed using a transsylvian-insular approach.
- Histopathological and radiological characteristics of this unusual PAA were documented.
- This case represents a PAA localized entirely within the limen insulae.
Implications:
- PAAs, though rare, should be considered in the differential diagnosis of atypical intracerebral hemorrhages in young to middle-aged individuals.
- The transsylvian-insular approach is a viable surgical option for managing insular PAA.
- Understanding the unique anatomical location and presentation of PAAs is crucial for timely diagnosis and effective treatment.
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