Aneurysm formation and rupture at the site of anastomosis following bypass surgery. Case report.
Four years after undergoing a superficial temporal artery-middle cerebral artery bypass procedure, this patient presented with a ruptured aneurysm at the anastomosis site. The ruptured aneurysm caused subarachnoid and intracerebral hemorrhages and was treated by surgically clipping its neck. Characteristics of the aneurysm included: 1) a relatively large size (8 x 6 x 6 mm): 2) a thickened wall; 3) a location apart from the suture line; 4) a projection in a direction consistent with hemodynamic stress; and 5) a time interval from bypass surgery to rupture that lasted 4 years. These features, along with the well-known fact that hemodynamic stress can cause aneurysms, led the authors to believe that this aneurysm was a true one. The authors present a case of this unusual complication following bypass surgery and provide a brief review of the literature.
Sasaki
T
T
Department of Neurosurgery, Fukushima Medical School, Japan.
Kodama
N
N
Itokawa
H
H
D000714:Anastomosis, Surgical; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging / Q000601:surgery