Carotid rete mirabile associated with subarachnoid hemorrhage from intracranial aneurysm: A case report and systematic review.
Carotid rete mirabile (CRM) is a rare physiological vascular network in humans that is most often found in Eastern populations. This paper describes a CRM associated with an aneurysmal subarachnoid hemorrhage (aSAH) and discusses the details of the patient's treatment. A 28-year-old woman was admitted to our service with clinical signs and symptoms of a spontaneous aSAH. Computed tomography revealed a diffuse and extensive SAH (Fisher group IV), while an angiogram showed an abnormal collateral network in the right carotid system and a hypoplastic aspect to the internal carotid artery (ICA) on the same side. In addition, a saccular aneurysm with a diameter of 9.5 mm was present in the ophthalmic segment of the left ICA. This case is extremely uncommon. To avoid rebleeding in the patient, we successfully treated the patient by clipping the aneurysmal lesion. No procedure was performed for the CRM.
Division of Neurosurgery, Hospital Ophir Loyola, Federal University of Para, Belem, Brazil ericpaschoal@yahoo.com.br.
Eric Homero Albuquerque
EH
Paschoal
Division of Neurosurgery, Hospital Ophir Loyola, Federal University of Para, Belem, Brazil.
Vitor Nagai
VN
Yamaki
Division of Neurosurgery, Hospital Ophir Loyola, Federal University of Para, Belem, Brazil.
Fernando Mendes Paschoal
FM
Júnior
Division of Neuroradiology, Hospital Beneficência Portuguesa de São Paulo, São Paulo, Brazil.
Ronie Leo
RL
Piske
Division of Neurosurgery, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
Manoel Jacobsen
MJ
Teixeira
Division of Neurosurgery, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
Edson
E
Bor-Seng-Shu
D000328:Adult; D063405:Anatomic Variation; D002339:Carotid Arteries / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000601:surgery; D013345:Subarachnoid Hemorrhage / Q000209:etiology* / Q000601:surgery
Cerebrovascular disorders; case report; collateral circulation; subarachnoid hemorrhage