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Double bilateral symmetrical aneurysms--case report

C Kadoya1, Y Momota, E Urasaki

  • 1Department of Neurosurgery, School of Medicine, University of Occupational and Environmental Health, Fukuoka.

Neurologia Medico-Chirurgica
|January 1, 1994
PubMed
Summary
This summary is machine-generated.

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This case highlights the challenge of identifying all intracranial aneurysms, particularly distal anterior cerebral artery aneurysms, during initial preoperative angiography. It suggests avoiding bilateral surgical approaches in a single stage for multiple complex aneurysms.

Area of Science:

  • Neurosurgery
  • Vascular Neurology
  • Radiology

Background:

  • Subarachnoid hemorrhage (SAH) necessitates prompt diagnosis and treatment of associated intracranial aneurysms.
  • Middle cerebral artery (MCA) aneurysms are common, but the presence of multiple or distal aneurysms can complicate surgical planning.

Observation:

  • A patient presenting with SAH had bilateral symmetrical MCA aneurysms successfully clipped.
  • Postoperative imaging revealed previously undetected bilateral symmetrical distal anterior cerebral artery aneurysms, which were also successfully treated.

Findings:

  • Preoperative angiography failed to identify distal anterior cerebral artery aneurysms that were evident postoperatively.
  • The successful clipping of all identified aneurysms was achieved, but challenges in initial detection were noted.

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Implications:

  • This case underscores the potential for missed aneurysms on initial angiography, especially in distal locations.
  • It suggests that a staged, rather than a one-stage bilateral, surgical approach may be prudent for managing multiple complex intracranial aneurysms to ensure complete identification and treatment.