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 Brain Aneurysms:

 

  • Approximately 80-90% of non-traumatic subarachnoid hemorrhages (spontaneous bleed in the subarachnoid space of the brain) is due to aneurysm rupture.
  • ACOM (Anterior Communicating Artery) aneurysms are among the most common, representing approximately 1/3 of intracranial aneurysms.
  • Large ACOM aneurysms can present with an optic chiasmal syndrome (bitemporal hemianopsia or loss of peripheral vision) as well as subarachnoid hemorrhage.
  • Approximately up to 20% of patients can have multiple aneurysms. Although any size aneurysm may rupture, those measuring greater than 3-5 mm are known to be at higher risk.
  • It is estimated that with subarachnoid hemorrhage due to rupture of an aneurysm  1/3 of patients die immediately, 1/3 will have long term neurological deficit, and only 1/3 will have normal outcome.
  • A multimodality approach to aneurysms including interventional radiologist or interventional neurosurgeon and vascular neurosurgeon is essential to optimize the approach to the aneurysm.

 

 

Brain Aneurysm Case Presentation

  • 61 year old woman presented with severe headache followed by sudden loss of consciousness.

CT scan of patient’s brain shows a sever subarachnoid hemorrhage and hydrocephalus (yellow arrow show enlarged ventricles)

 

 

CTA (Computer Tumographic Angiography) of patient’s brain showed a complex anterior communicating aneurysm.

 

 

 

MRA (Magnetic Resonance Angiography), and 4 vessel Cerebral angiography confirmed a complex multi-lobulated anterior communicating aneurysm which was not amenable to interventional approach due to its complex morphology.

 

 

 

Patient underwent supra-orbital craniotomy and clipping of the aneurysm. Postoperative angiogram showed complete treatment of the aneurysm. This patient was discharged to home shortly after the operation with no complication and in good health.

 

  

 

 

 

 

 

 





 

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