[Two cases of giant fusiform aneurysm presenting ischemic attacks].
It is said that major clinical sign of giant fusiform aneurysm is so-called mass sign compressing surrounding tissues and ischemic attack caused by the aneurysm is very rare. The authors experienced such uncommon two patients with partially thrombosed fusiform aneurysm who developed ischemic attack. Case 1: A 68-year-old man was admitted to our hospital in semicomatous state with ocular bobbing and decorticate posture of sudden onset. Enhanced CT scans taken at admission showed a presence of homogenously enhanced mass continuing to bilateral posterior cerebral arteries, which compressed the pons from right ventro-lateral side (Fig. 1 a,b). Plain CT scan taken 10 days after admission demonstrated extensive low density area in the pons (Fig. 1c). Basilar artery and P1 segment of the right posterior cerebral artery are ectatic, tortuous and elongated (Fig. 2a). The ectatic basilar artery was displaced upward and posteriorly (Fig. 2b). He developed locked-in syndrome and died of pneumonia six months after admission. At autopsy, large aneurysm measuring 3.5 X 2.0 X 1.9 cm was verified in the basilar artery (Fig. 3a). Cross section of the basilar artery aneurysm showed that laminated thrombosis nearly occupied the lumen with partially unobstructed portion (Fig. 3b). Also, horizontal section of the pons demonstrated a presence of old infarction located in the perforating arteries territory (Fig. 3c). Case 2: A 42-year-old man was initially hospitalized in 1978 because of multiple intracranial meningiomas and subtotal removal of meningiomas located in the tuberculum sellae and the foramen magnum was performed.(ABSTRACT TRUNCATED AT 250 WORDS)
D000368:Aged; D001488:Basilar Artery / Q000473:pathology; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D002533:Cerebral Angiography; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D014711:Vertebral Artery / Q000473:pathology