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Aneurysms associated with non-moyamoya collateral arterial networks: report of three cases and review of literature

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Disclosure

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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Authors and Affiliations

  1. Department of Neurological Surgery, University of California at San Francisco, 505 Parnassus Avenue, M780, San Francisco, CA, 94143-0112, USA

    Ana Rodríguez-Hernández, Daniel C. Lu, Susanna Miric & Michael T. Lawton

Authors
  1. Ana Rodríguez-Hernández
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  2. Daniel C. Lu
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  3. Susanna Miric
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  4. Michael T. Lawton
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Correspondence to Ana Rodríguez-Hernández.

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Comments

Kiyohiro Houkin, Sapporo, Japan

This paper offers us with interesting cases of small ruptured cerebral aneurysms seen in the collateral circulation with the occluded main arteries and extensive review of literatures.

A similar review article has been published in Acta Neurochir (Wien) 2010 Mar;152(3):515–518 by our colleagues, Hokari et al. The authors have suggested that small aneurysms that are not located in the main intracranial arteries are closely related to the hemodynamic stress due to vascular anomaly including moyamoya vessels.

In term of treatment, simple surgical resection of cerebral aneurysm has been performed in most reported cases since the aneurysms are located in the very distal of the collateral circulation. In other words, the bypass surgery is not always supposed to be indispensable in these cases.

We believe that vascular reconstruction should be simultaneously performed in these cases considering the pathological condition due to subarachnoid hemorrhage when it is technically possible. The vascular reconstruction in acute stage of subarachnoid hemorrhage is considered not to be high risk.

These cases are suggestive that hemodynamic stress is an absolutely important factor in the mechanism of the formation of small aneurysms in the distal circulation. In other words, as seen in moyamoya disease, artificial hemodynamic modulation by bypass surgery can reduce the risk of rupture of these small aneurysms.

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Rodríguez-Hernández, A., Lu, D.C., Miric, S. et al. Aneurysms associated with non-moyamoya collateral arterial networks: report of three cases and review of literature. Neurosurg Rev 34, 517–522 (2011). https://doi.org/10.1007/s10143-011-0342-5

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  • DOI: https://doi.org/10.1007/s10143-011-0342-5

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