Abstract
Intracranial aneurysms arising from the distal anterior choroidal artery (AChA) are uncommon entities, with less than 30 cases reported. A 4-year-old boy was admitted to the Emergency Department with a sudden onset of severe headache and vomiting. CT scan of the head showed signs of intraventricular hemorrhage (IVH) and subarachnoid hemorrhage (SAH). Cerebral angiography revealed a right AChA aneurysm arising from a distal intraventricular branch with an associated microarteriovenous malformation (microAVM). Following a multidisciplinary assessment, the patient underwent surgical clipping. An ipsilateral transcortical transparietal approach was utilized. Early postoperative deficits were not found, and good clinical and radiological outcomes were assessed at long-term follow-up. Postoperative cerebral angiography showed complete exclusion and resection of both aneurysm and AVM. Surgery for intracranial aneurysms in this location can be challenging; however, good surgical and neurological outcomes can be achieved. The present work highlights the value of multidisciplinary assessment in the decision-making process in complex pediatric neurovascular pathology, especially when facing rare cases like this one, which represents the youngest case of a ruptured distal AChA aneurysm reported in the literature.
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Abbreviations
- ACHA:
-
Anterior choroidal artery
- AVM:
-
Arteriovenous malformation
- CT:
-
Computed tomography
- GCS:
-
Glasgow Coma Scale
- ICA:
-
Internal carotid artery
- IVH:
-
Intraventricular hemorrhage
- MRI:
-
Magnetic resonance imaging
- SAH:
-
Subarachnoid hemorrhage
- WFNS:
-
World Federation of Neurosurgical Societies
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I would like to express my special thanks of gratitude to Dr. Jorge Zamorano Fernández for helping us during the critical review of the manuscript corrections once it had been considered for publication.
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All authors contributed to the study conception and design. The first draft of the manuscript was written by Pablo García Feijoo, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Feijoo, P.G., Gutiérrez, J.M.S., Martínez, R.F. et al. Management of a ruptured intraventricular aneurysm arising from distal anterior choroidal artery (AChA): pediatric case report. Childs Nerv Syst 37, 1791–1796 (2021). https://doi.org/10.1007/s00381-020-04888-w
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DOI: https://doi.org/10.1007/s00381-020-04888-w