Ruptured distal anterior choroidal artery aneurysm.
Ruptured aneurysms of the distal anterior choroidal artery (AchA) are extremely rare and management is dictated by clinical presentation. This report describes a rare patient with a distal AchA aneurysm and subarachnoid and intraventricular haemorrhage. A 60-year-old woman presented with a sudden onset of severe headache and vomiting. No aneurysms could be found on initial angiograms. A repeat angiogram performed 10 days after admission demonstrated an aneurysm in a branch of the cisternal segment of the left AchA without a definite neck. Surrounding vessels showed multifocal stricture and dilatation. Microsurgical clipping was not performed because the patient died suddenly due to pulmonary failure. The aetiology of the aneurysm in this case and surgical strategy are discussed.
Ahn
Jung Yong
JY
Department of Neurosurgery, Yongdong Severance Hospital Yonsei University College of Medicine, 146-92, Dogok-Dong, Kangnam-Du, Seoul, South Korea. jyahn@yumc.yonsei.ac.kr
Han
In Bo
IB
Hong
Chang Ki
CK
Joo
Jin Yang
JY
D017542:Aneurysm, Ruptured / Q000150:complications / Q000473:pathology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002533:Cerebral Angiography; D002831:Choroid Plexus / Q000098:blood supply* / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000473:pathology*; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D011015:Pneumonia, Aspiration / Q000150:complications / Q000188:drug therapy; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy; D013211:Staphylococcus aureus; D013345:Subarachnoid Hemorrhage / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D010406:Penicillins; D014640:Vancomycin