Abstract
We report on a patient with fibromuscular dysplasia who presented with a right-sided giant calcified cavernous internal carotid artery (ICA) aneurysm and two additional supraophthalmic ICA aneurysms. Endovascular closure of the right ICA using detachable balloons was performed with collateralisation of the right hemisphere via the right-sided posterior communicating and the anterior communicating arteries. Repeat angiography after 6 months demonstrated spontaneous complete regression of the two supraophthalmic aneurysms, although the parent vessel was still perfused. In comparison to the former angiography, the flow within the parent vessel was reversed due to the proximal ICA balloon occlusion. MRI demonstrated that the aneurysms were not obliterated by thrombosis alone, but showed a real regression in size. This case report demonstrates that changes in cerebral hemodynamics potentially lead to plastic changes in the vessel architecture in adults and that aneurysms can be flow-related, even if not associated with high flow fistulas or arteriovenous malformations, especially in cases with an arterial wall disease.
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References
Redekop G, TerBrugge K, Montanera W, Willinsky R (1998) Arterial aneurysms associated with cerebral arteriovenous malformations: classification, incidence, and risk of hemorrhage. J Neurosurg 89:539–546
Senn P, Krauss JK, Remonda L, Godoy N, Schroth G (2000) The formation and regression of a flow-related cerebral artery aneurysm. Clin Neurol Neurosurg 102:168–172
Yeh H, Tomsick TA (1997) Obliteration of a giant carotid aneurysm after extracranial-to-intracranial bypass surgery: case report. Surg Neurol 48:473–476
Cantore G, Santoro A, Da Pian R (1999) Spontaneous occlusion of supraclinoid aneurysms after the creation of extra-intracranial bypasses using long grafts: report of two cases. Neurosurgery 44:216–219; discussion 219–220
Lasjaunias P, Berenstein A, TerBrugge K (2001) Surgical neuroangiography. Part I. Clinical vascular anatomy and variations. Springer, Berlin Heidelberg New York
Gibbons GH, Dzau VJ (1994) The emerging concept of vascular remodeling. N Engl J Med 330:1431–1438
Langille BL, O’Donnell F (1986) Reductions in arterial diameter produced by chronic decreases in blood flow are endothelium-dependent. Science 231:405–407
Brownlee RD, Langille BL (1991) Arterial adaptations to altered blood flow. Can J Physiol Pharmacol 69:978–983
Huber P (1982) Cerebral angiography. Thieme, Stuttgart
Steinberg GK, Drake CG, Peerless SJ (1993) Deliberate basilar or vertebral artery occlusion in the treatment of intracranial aneurysms. Immediate results and long-term outcome in 201 patients. J Neurosurg 79:161–173
Drake CG (1975) Ligation of the vertebral (unilateral or bilateral) or basilar artery in the treatment of large intracranial aneurysms. J Neurosurg 43:255–274
Cloft HJ, Kallmes DF, Kallmes MH, Goldstein JH, Jensen ME, Dion JE (1998) Prevalence of cerebral aneurysms in patients with fibromuscular dysplasia: a reassessment. J Neurosurg 88:436–440
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Hans, F.J., Krings, T., Reinges, M.H.T. et al. Spontaneous regression of two supraophthalmic internal cerebral artery aneurysms following flow pattern alteration. Neuroradiology 46, 469–473 (2004). https://doi.org/10.1007/s00234-004-1204-4
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DOI: https://doi.org/10.1007/s00234-004-1204-4