title: Giant serpentine aneurysm in a long-term hemodialysis patient.
abstract: A long-term hemodialysis patient with a giant intracranial vascular channel, which has been called a giant serpentine aneurysm, is presented. A 50-year-old man with an eight-year history of hemodialysis treatment was admitted because of headache, nausea and double vision. Computed tomographic scans and nuclear magnetic resonance revealed intracranial abnormal shadow. The left vertebral arteriography showed that the distal portion of the left vertebral artery was dilated to 17 mm in diameter. The basilar artery showed a large tortuous vascular channel and globular aneurysms over 25 mm in diameter. This giant serpentine aneurysm is a rather rare disease. To our knowledge, it has not been reported as a complication in a hemodialysis patient, although fourteen cases have been reported in the literature. In our case, several conditions such as long-term hypertension, hyperlipidemia, hypercalcemia, atherosclerosis and abnormal blood flow due to arteriovenous fistula for hemodialysis treatment might be considered to play a role in the formation of the giant serpentine aneurysms.
authors.affiliation: Second Department of Internal Medicine, Tokyo Medical and Dental University, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Terada
authors.forename: K
authors.initials: K
authors.lastname: Tomita
authors.forename: T
authors.initials: T
authors.lastname: Shinoda
authors.forename: Y
authors.initials: Y
authors.lastname: Iino
authors.forename: N
authors.initials: N
authors.lastname: Yoshiyama
mesh_terms: D001488:Basilar Artery; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed