Endovascular coil embolization of a ruptured distal anterior choroidal artery aneurysm associated with ipsilateral middle cerebral artery occlusion: Case report

Ayumi Nishida, Koji Tokunaga, Tomohito Hishikawa, Kenji Sugiu, Isao Date

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

An 84-year-old woman with a history of hypertension and a brain infarction presented with a rare distal anterior choroidal artery (AChoA) aneurysm not associated with moyamoya disease manifesting as sudden onset of headache caused by intraventricular hemorrhage. Digital subtraction angiography revealed a peripheral aneurysm in the left AChoA located distal to the plexal point and steno-occlusive changes of the proximal left middle cerebral artery (MCA) and the left posterior cerebral artery (PCA). Collateral arterial channels to the left MCA and left PCA territories were observed along the left AChoA. No neuroimaging findings were compatible with moyamoya disease. Since the aneurysm did not shrink at 2 months after the onset, endovascular treatment was indicated. Under local anesthesia, a microcatheter was placed into the AChoA proximal to the aneurysm with the aid of a 0.008-inch microguidewire. After a provocation test, three detachable platinum coils were delivered into the aneurysm and the parent artery. Complete obliteration of the aneurysm was achieved without additional neurological sequelae. Successful treatment of a ruptured distal AChoA aneurysm associated with atherosclerotic changes of the intracranial arteries was achieved using a meticulous endovascular technique.

Original languageEnglish
Pages (from-to)716-719
Number of pages4
JournalNeurologia Medico-Chirurgica
Volume51
Issue number10
DOIs
Publication statusPublished - 2011

Fingerprint

Middle Cerebral Artery Infarction
Aneurysm
Arteries
Posterior Cerebral Artery
Moyamoya Disease
Middle Cerebral Artery
Brain Infarction
Endovascular Procedures
Digital Subtraction Angiography
Local Anesthesia
Platinum
Neuroimaging
Headache
Hemorrhage
Hypertension
Therapeutics

Keywords

  • Anterior choroidal artery
  • Atherosclerosis
  • Embolization
  • Intracranial aneurysm
  • Pathogenesis

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

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abstract = "An 84-year-old woman with a history of hypertension and a brain infarction presented with a rare distal anterior choroidal artery (AChoA) aneurysm not associated with moyamoya disease manifesting as sudden onset of headache caused by intraventricular hemorrhage. Digital subtraction angiography revealed a peripheral aneurysm in the left AChoA located distal to the plexal point and steno-occlusive changes of the proximal left middle cerebral artery (MCA) and the left posterior cerebral artery (PCA). Collateral arterial channels to the left MCA and left PCA territories were observed along the left AChoA. No neuroimaging findings were compatible with moyamoya disease. Since the aneurysm did not shrink at 2 months after the onset, endovascular treatment was indicated. Under local anesthesia, a microcatheter was placed into the AChoA proximal to the aneurysm with the aid of a 0.008-inch microguidewire. After a provocation test, three detachable platinum coils were delivered into the aneurysm and the parent artery. Complete obliteration of the aneurysm was achieved without additional neurological sequelae. Successful treatment of a ruptured distal AChoA aneurysm associated with atherosclerotic changes of the intracranial arteries was achieved using a meticulous endovascular technique.",
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AU - Sugiu, Kenji

AU - Date, Isao

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