Injuries of the Cingulum and Fornix After Rupture of an Anterior Communicating Artery Aneurysm: A Diffusion Tensor Tractography Study

Abstract BACKGROUND: After rupture of an anterior communicating artery (ACoA) aneurysm, the anterior cingulum and the fornix can be vulnerable to injury. However, very little is known about this topic. OBJECTIVE: To investigate injuries of the cingulum and fornix in patients with an ACoA aneurysm rupture with diffusion tensor tractography. METHODS: Eleven consecutive patients with an ACoA aneurysm rupture and 11 age- and sex-matched normal control subjects were recruited. Diffusion tensor imaging was scanned at an average of 54.1 days (range, 29–97 days) after onset of ACoA aneurysm rupture. RESULTS: We found that 6 (54.5%) and 7 (63.6%) of 11 patients revealed no trajectory of the anterior cingulum and the fornical body on diffusion tensor tractography, respectively. In terms of diffusion tensor imaging parameters, we found that the fractional anisotropy value and tract volume of the cingulum and fornix were decreased (P < .05) and that mean diffusivity values were increased (P < .05), except for those of the left fornix, which showed no difference (P > .05). CONCLUSION: We found injuries of the cingulum and fornix in patients with an ACoA aneurysm rupture. It is our belief that sustained memory impairment of patients with an ACoA aneurysm rupture might be related to injury of the cingulum and fornix. Therefore, we recommend evaluation of the cingulum and fornix with diffusion tensor tractography for patients with an ACoA aneurysm rupture.

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Re: Morphological risk model assessing anterior communicating artery aneurysm rupture: Development and Validation

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2021.106758 ◽

2021 ◽

pp. 106758

Author(s):

Anahid Hamidianjahromi ◽

Ashkan Mowla

Keyword(s):

Risk Model ◽

Artery Aneurysm ◽

Aneurysm Rupture ◽

Anterior Communicating Artery ◽

Anterior Communicating Artery Aneurysm ◽

Development And Validation

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Coaxial Access for Microcatheter Stabilization During Aneurysm Coiling: 2-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opab100 ◽

2021 ◽

Author(s):

Miri Kim ◽

Rachyl Shanker ◽

Anthony Kam ◽

Matthew Reynolds ◽

Joseph C Serrone

Keyword(s):

Artery Aneurysm ◽

Anterior Communicating Artery ◽

Distal Catheter ◽

Anterior Communicating Artery Aneurysm ◽

Class 1 ◽

Previously Treated ◽

Aneurysm Occlusion ◽

Intracranial Circulation ◽

Aneurysm Coiling

Abstract Coaxial support is a fundamental technique utilized by neurointerventionalists to optimize distal catheter control within the intracranial circulation. Here we present a 41-yr-old woman with a previously coiled ruptured anterior communicating artery aneurysm with progressive recurrence harboring tortuous internal carotid anatomy to demonstrate the utility of coaxial support. Raymond-Roy classification of initial aneurysm coiling of class 1 resulted as class 3b over the 21 mo from initial treatment.1 The patient consented to stent-assisted coiling for retreatment of this aneurysm. Coaxial support was advanced as distally as possible in the proximal vasculature to improve catheter control, reducing dead space within which the microcatheter could move, decreasing angulations within proximal vasculature, limiting the movement of the native vessels, and providing a surface of lower friction than the endothelium. As the risk of recurrent subarachnoid hemorrhage in previously treated coiled aneurysms approaches 3%, retreatment occurs in 16.4% within 6 yr2 and in 17.4% of patients within 10 yr.3 Rerupture is slightly higher in patients who underwent coiling vs clipping, with the rerupture risk inversely proportional to the degree of aneurysm occlusion,4 further substantiating that coaxial support provides technical advantage in selected patients where additional microcatheter control is necessary for optimal occlusion. Pitfalls of this technique include vasospasm and vascular injury, which can be ameliorated by pretreatment of the circulation with vasodilators to prevent catheter-induced vasospasm. This case and model demonstration illustrates the technique of coaxial access in the stent-assisted coiling of a recurrent anterior communicating artery aneurysm and identification and management of catheter-induced vasospasm.

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Totally thrombosed giant anterior communicating artery aneurysm

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.150280 ◽

2015 ◽

Vol 6 (02) ◽

pp. 245-247

Author(s):

V. R. Roopesh Kumar ◽

Venkatesh S. Madhugiri ◽

Gopalakrishnan M. Sasidharan ◽

Sudheer Kumar Gundamaneni ◽

Awdhesh Kumar Yadav ◽

...

Keyword(s):

Urinary Incontinence ◽

Preoperative Diagnosis ◽

Relevant Literature ◽

Artery Aneurysm ◽

Anterior Communicating Artery ◽

Gait Ataxia ◽

Visual Dysfunction ◽

Anterior Communicating Artery Aneurysm

ABSTRACTGiant anterior communicating artery aneurysmsarerare. Apatient presented with visual dysfunction, gait ataxia and urinary incontinence. MRI showed a giant suprasellar mass.At surgery, the lesion was identified as being an aneurysm arising from the anterior communicating artery.The difficulty in preoperative diagnosis and relevant literature are reviewed.

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