title: Are infundibular dilatations at risk of further transformation? Ten-year progression of a prior documented infundibulum into a saccular aneurysm and rupture: Case report and a review of the literature.
abstract: Infundibular dilatations (IFDs) are conical, triangular, or funnel-shaped enlargements at the origin of cerebral arteries, and they are primarily located (7-25%) on the posterior communicating artery (PComA). Progression over time into a saccular aneurysm with a risk of rupture of a previously demonstrated IFD has rarely been reported. We report the case of a 60-year-old female who presented 10 years earlier with a subarachnoid hemorrhage caused by a left internal carotid artery aneurysm rupture. At that time, the carotid angiography showed the left internal carotid artery aneurysm and a right posterior communicating artery infundibular dilatation. Neck clipping for the left internal carotid artery aneurysm was performed and the patient was discharged with no neurological deficit. Ten years later, the patient suffered a second fatal subarachnoid hemorrhage; carotid angiography revealed a right posterior communicating artery aneurysm developed from the previously documented infundibular dilatation with a de novo right anterior choroidal artery aneurysm. This case is another proof of the small but growing number of examples of infundibular transformation over time, as well as their risk of progression into saccular aneurysms and subsequent rupture.
authors.affiliation: Department of Neurosurgery, Mohamed Vth, University, School of Medicine, Hôpital des Spécialités, ONO CHU Ibn Sina, Rabat 10100, Morocco. Electronic address: clairekarekezi@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Karekezi
authors.affiliation: Department of Neurosurgery, Mohamed Vth, University, School of Medicine, Hôpital des Spécialités, ONO CHU Ibn Sina, Rabat 10100, Morocco.
authors.forename: M
authors.initials: M
authors.lastname: Boutarbouch
authors.affiliation: Department of Neurosurgery, Mohamed Vth, University, School of Medicine, Hôpital des Spécialités, ONO CHU Ibn Sina, Rabat 10100, Morocco.
authors.forename: B O
authors.initials: BO
authors.lastname: Djoubairou
authors.affiliation: Department of Neurosurgery, Mohamed Vth, University, School of Medicine, Hôpital des Spécialités, ONO CHU Ibn Sina, Rabat 10100, Morocco.
authors.forename: A
authors.initials: A
authors.lastname: Melhaoui
authors.affiliation: Department of Neurosurgery, Mohamed Vth, University, School of Medicine, Hôpital des Spécialités, ONO CHU Ibn Sina, Rabat 10100, Morocco.
authors.forename: Y
authors.initials: Y
authors.lastname: Arkha
authors.affiliation: Department of Neurosurgery, Mohamed Vth, University, School of Medicine, Hôpital des Spécialités, ONO CHU Ibn Sina, Rabat 10100, Morocco.
authors.forename: A
authors.initials: A
authors.lastname: El Ouahabi
mesh_terms: D017542:Aneurysm, Ruptured / Q000209:etiology*; D002340:Carotid Artery Diseases / Q000209:etiology; D002343:Carotid Artery, Internal / Q000473:pathology; D004108:Dilatation, Pathologic; D018450:Disease Progression; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000209:etiology*; D008875:Middle Aged; D012306:Risk; D013345:Subarachnoid Hemorrhage / Q000209:etiology; D013997:Time Factors
keywords: Anévrismes intracrâniens; Artère communicante postérieure; Hémorragie méningée; Infundibular dilatation; Infundibulum; Intracranial aneurysms; Posterior communicating artery; Subarachnoid hemorrhage