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Hemodynamic Impact of a Spontaneous Cervical Dissection on an Ipsilateral Saccular Aneurysm
| Content Provider | Semantic Scholar |
|---|---|
| Author | See, Alfred P. Gross, Bradley A. Penn, David Lewis Du, Rose Frerichs, Kai U. |
| Copyright Year | 2016 |
| Abstract | The dynamic, hemodynamic impact of a cervical dissection on an ipsilateral, intracranial saccular aneurysm has not been well illustrated. This 45-year-old female was found to have a small, supraclinoid aneurysm ipsilateral to a spontaneous cervical internal carotid artery dissection. With healing of the dissection, the aneurysm appeared to have significantly enlarged. Retrospective review of the magnetic resonance imaging (MRI) at the time of the initial dissection demonstrated thrombus, similar in overall morphology to the angiographic appearance of the "enlarged" aneurysm. As the dissection healed far proximal to the intradural portion of the internal carotid artery, this suggested that the aneurysm was likely a typical, saccular posterior communicating artery aneurysm that had thrombosed and then recanalized secondary to flow changes from the dissection. The aneurysm was coiled uneventfully, in distinction from more complex treatment approaches such as flow diversion or proximal occlusion to treat an enlarging, dissecting pseudoaneurysm. This case illustrates that flow changes from cervical dissections may result in thrombosis of downstream saccular aneurysms. With healing, these aneurysms may recanalize and be misidentified as enlarging dissecting pseudoaneurysms. Review of an MRI from the time of the dissection facilitated the conclusion that the aneurysm was a saccular posterior communicating artery aneurysm, influencing treatment approach. |
| Starting Page | 110 |
| Ending Page | 114 |
| Page Count | 5 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://synapse.koreamed.org/Synapse/Data/PDFData/2098JCEN/jcen-18-110.pdf |
| PubMed reference number | 27790401v1 |
| Volume Number | 18 |
| Journal | Journal of cerebrovascular and endovascular neurosurgery |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Aneurysm, Dissecting Carotid Arteries Carotid Artery, Internal, Dissection Carotid artery dissection Enlargement procedure Hemodynamics Internal carotid artery structure Intracranial Aneurysm Magnetic Resonance Imaging Neck Pseudoaneurysm Saccular Aneurysm Structure of posterior communicating artery Thrombosis Tissue Dissection Vascular calcification |
| Content Type | Text |
| Resource Type | Article |
