Endovascular glue embolization of dissecting aneurysm of type-3 accessory middle cerebral artery: A contralateral approach.
Pediatric intracranial aneurysms are rare with a reported prevalence of 0.5-4.6%. Likewise, anomalous arterial patterns are uncommon in the cerebral circulation. Recognition of these variations and knowledge of vascular territory forms the key to managing pathological conditions associated with these anomalous vessels. Ruptured dissecting aneurysm of type-3 accessory middle cerebral artery (aMCA) has not been reported in the pediatric age group. In addition to type-3 aMCA, the child in this case report had an ipsilateral type-1 aMCA with cortical supply. We describe the patterns of accessory MCA and their vascular territory, state the perplexity involved in deciding the best management strategy, and describe the technical approach we undertook to catheterize this small caliber recurrent artery (type-3 aMCA) originating at an acute angle from the anterior cerebral artery.
Department of Neurointerventional Surgery, Medanta Institute of Neuroscience, Gurgaon, India.
Rajsrinivas
R
Parthasarathy
Department of Neurointerventional Surgery, Medanta Institute of Neuroscience, Gurgaon, India Gaurav.Goel@Medanta.org.
Gaurav
G
Goel
Department of Neurointerventional Surgery, Medanta Institute of Neuroscience, Gurgaon, India.
Vipul
V
Gupta
Department of Neurosurgery, Medanta Institute of Neuroscience, Gurgaon, India.
Karanjit Singh
KS
Narang
Department of Neuroanaesthesia and Critical Care, Medanta Institute of Neuroscience, Gurgaon, India.
Saurabh
S
Anand
Department of Neurosurgery, Medanta Institute of Neuroscience, Gurgaon, India.
Ajaya Nand
AN
Jha
D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000628:therapy*; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000628:therapy*; D002533:Cerebral Angiography; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D020768:Middle Cerebral Artery; D014014:Tissue Adhesives / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
D014014:Tissue Adhesives
Dissecting aneurysm; accessory middle cerebral artery; glue embolization; recurrent artery of Heubner