Distal anterior choroidal artery aneurysms.
BACKGROUND
Distal AChoA aneurysms are quite rare. Only 12 operated cases have been reported in the English medical literature. Treatment of these aneurysms is also difficult because of their deep location, small size, and angioarchitecture.


METHODS
The authors report 2 additional patients with aneurysms, arising from the distal AChoA and located within the temporal horn of the lateral ventricle. In the first patient, the aneurysm could also be visualized with CTA, which is the first demonstration in the literature.


RESULTS
The aneurysms were explored and resected via a transtemporal/ventricular approach in both patients. One patient was discharged as neurologically intact and the other died because of severe vasospasm.


CONCLUSIONS
The conclusions drawn from our experience and a comprehensive review of the literature include the following: (1) A distal AChoA aneurysm should be considered in patients with isolated medial temporal intracerebral hematoma with intraventricular extension. (2) These aneurysms are frequently very small (<5 mm). Therefore, they cannot be detected on initial angiograms in some cases. (3) These small aneurysms cannot be usually clipped without sacrificing the parent artery. (4) Sacrificing distal AChoA (beyond the plexal point) does not usually cause any neurological deficit, but, whenever possible, this artery should be preserved.
Inci
Servet
S
Department of Neurosurgery, School of Medicine, Hacettepe University, 06510 Ankara, Turkey. servet@mailcity.com
Arat
Anil
A
Ozgen
Tuncalp
T
D000328:Adult; D017542:Aneurysm, Ruptured / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D002831:Choroid Plexus / Q000098:blood supply*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome