scholarly journals Two Similar Cases of a Misdiagnosed Anterior Communicating Aneurysm Rupture

2021 ◽  
pp. 218-224
Author(s):  
Jaromir Hanuska ◽  
Jan Klener
Keyword(s):  
Clinical Presentation ◽  
Blood Clot ◽  
Delayed Diagnosis ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Anterior Communicating Artery ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Anterior Communicating Aneurysm ◽  
Mild Clinical Presentation

The misdiagnosis of a ruptured aneurysm directly endangers patient’s life and health due to the high risk of rebleeding and its sequelae. In this paper, we present two uncommon cases of anterior communicating artery aneurysm rupture with a relatively small intracerebral bleeding, seemingly without a diffuse subarachnoid hemorrhage (SAH), and a relatively mild clinical presentation. In these cases, the initial diagnosis failed, leading to missed aneurysmal ruptures. The atypical or mild clinical presentation, and the absence of SAH on computed tomography (CT) and/or magnetic resonance imaging (MRI) scan or absent blood in the cerebrospinal fluid (CSF) are all factors which could lead to a false or delayed diagnosis. Meticulous evaluation of patient’s symptoms, CT, MRI scans, and CSF findings are mandatory. The possibility of a small blood clot without a diffuse SAH must be considered.

scholarly journals Anterior Communicating Artery Aneurysm Uncommon Hemorrhagic Presentation: Case Report

2020 ◽  
Vol 39 (01) ◽  
pp. 054-057
Author(s):  
Dan Zimelewicz Oberman ◽  
Nicollas Nunes Rabelo ◽  
Rafael Rego Barros ◽  
Othavio Lopes ◽  
Jorge Amorim
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Intracerebral Hemorrhage ◽  
Intraventricular Hemorrhage ◽  
Unusual Case ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Anterior Communicating Artery ◽  
Anterior Communicating Aneurysm ◽  
Head Computed Tomography

AbstractIntracranial aneurysm rupture causes subarachnoid hemorrhage in 80% of the cases, and it may be associated with intracerebral hemorrhage and/or intraventricular hemorrhage (IVH) in 34% and 17% of the patients, respectively. However, on rare occasions, aneurysm rupture may be present causing isolate intracerebral hemorrhage or IVH without subarachnoid hemorrhage.We describe an unusual case of an anterior communicating aneurysm rupture presented with IVH, without subarachnoid hemorrhage.Although isolated IVH is rare, aneurysm rupture is a possible condition. Patients presenting with head computed tomography revealing IVH without subarachnoid hemorrhage should be promptly investigated with contrasted image exam to identify and treat possible causes, even in the absence of subarachnoid hemorrhage.

Analysis of Anterior Cerebral Artery Tortuosity: Association with Anterior Communicating Artery Aneurysm Rupture

2019 ◽  
Vol 122 ◽  
pp. e480-e486 ◽  
Author(s):  
Roger M. Krzyżewski ◽  
Kornelia M. Kliś ◽  
Borys M. Kwinta ◽  
Małgorzata Gackowska ◽  
Krzysztof Stachura ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Anterior Communicating Artery ◽  
Anterior Communicating Artery Aneurysm

scholarly journals Neuropsychological rehabilitation in a patient with ruptured anterior communicating artery aneurysm: 48 month outcomes

2007 ◽  
Vol 1 (4) ◽  
pp. 407-411 ◽  
Author(s):  
Silvia A. Prado Bolognani ◽  
Priscila Covre ◽  
Daniella Landucci-Moreira ◽  
Thiago S. Rivero ◽  
Sonia Maria Dozzi Brucki ◽  
...  
Keyword(s):  
Cognitive Rehabilitation ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Anterior Communicating Artery ◽  
Post Intervention ◽  
Efficient Manner ◽  
Neuropsychological Rehabilitation ◽  
Personality Changes ◽  
Supportive Family ◽  
Favorable Neurological Outcome

Abstract The neurobehavioral impairments associated with aneurysms of the anterior communicating artery (ACoA) are severe amnesia, executive problems and personality changes. Although most patients achieve a favorable neurological outcome, those cognitive deficits usually prevent return to previous activities and levels of social integration. Objectives: To report the outcomes of a neuropsychological and behavioral intervention in a 55 year-old man with very severe memory and executive dysfunctions following ACoA aneurysm rupture. Methods: Neuropsychological intervention focused in functional adjustment in everyday life was used, including individual sessions with the patient, discussion sessions with caregivers and also work with patient at home, aiming generalization of the rehabilitation strategies. Neuropsychological and functional assessments were conducted pre and post intervention. Results: Important improvements were seeing in behavior and daily living performance after treatment. Conclusions: A neuropsychological rehabilitation approach focused on goals based on the family and caregivers necessities is an efficient manner in which to carry out cognitive rehabilitation in severe cases. The importance of a supportive family should be stressed.

ACROMEGALY UNVEILED DURING A NASAL RECONSTRUCTION SURGERY: A CASE REPORT

2021 ◽  
pp. 66-68
Author(s):  
Kiran Shah ◽  
Ishant Bhanarkar ◽  
Vasavdatta Sharma ◽  
Durvesh Bhangale ◽  
Vinod Pawara ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Delayed Diagnosis ◽  
Somatic Growth ◽  
Care Physician ◽  
Nasal Reconstruction ◽  
Thyroid Function Tests ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
New Diagnosis ◽  
Gh Excess

Acromegaly is a condition of excessive somatic growth and distorted proportion due to hypersecretion of growth hormone(GH) and insulin-like growth factor 1 (IGF-1). Insidious clinical manifestation of GH excess as a result of GH-secreting pituitary adenoma renders acromegaly a disease with typically delayed diagnosis. We report a 29-year old male planned to undergo reconstruction of the nose. The patient was referred for medical tness. Given the clinical features consistent with acromegaly the patient was evaluated further for diagnosis. Laboratory investigation showed raised IGF-1and non-suppressed GH post 75gms glucose, amid normal cortisol, corticotropin(ACTH), prolactin, testosterone, and thyroid function tests. He did not have dysglycemia. Magnetic resonance imaging (MRI) of the pituitary revealed a pituitary macroadenoma consistent with acromegaly. This case highlights the notable absence of recognizing the clinical presentation of acromegaly in this patient by his medical care physician and surgeons, and therefore the importance of thorough history taking, attention, and observation in making a new diagnosis that has the potential to alter a patient's health care and alleviate impending complications, morbidity and/or mortality

Ruptured anterior communicating artery aneurysm encased in a tuberculum sellae meningioma

1999 ◽  
Vol 91 (5) ◽  
pp. 871-874 ◽  
Author(s):  
Masahiro Ogino ◽  
Masashi Nakatsukasa ◽  
Toru Nakagawa ◽  
Ikuro Murase
Keyword(s):  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Anterior Communicating Artery ◽  
Resonance Imaging ◽  
Content Type ◽  
Intratumoral Hemorrhage ◽  
Tuberculum Sellae Meningioma ◽  
Anterior Communicating Artery Aneurysm ◽  
Preoperative Magnetic Resonance ◽  
Tuberculum Sellae

✓ This 70-year-old woman suffered a subarachnoid hemorrhage (SAH) from a ruptured anterior communicating artery aneurysm encased in a meningioma in the tuberculum sellae. Although preoperative magnetic resonance imaging disclosed that the aneurysmal complex was completely enclosed in the tumor, angiographic studies did not reveal arterial narrowing. The embedded aneurysm caused diffuse SAH rather than intratumoral hemorrhage. These factors indicated very little adhesion between the tumor and the encased arteries. Surgery was performed on the 20th day post-SAH. Intraoperative findings revealed that the tumor did not adhere to the enclosed vasculature except at the point of rupture of the aneurysm. The authors were able to clip the aneurysm safely after piecemeal removal of the tumor, which was finally extirpated without fear of aneurysm rupture. Careful stepwise procedures were essential to treat the aneurysm and the tumor simultaneously.

Computational Fluid Dynamics of a Fatal Ruptured Anterior Communicating Artery Aneurysm

2017 ◽  
Vol 78 (06) ◽  
pp. 610-616 ◽  
Author(s):  
Helena Švihlová ◽  
Alena Sejkorová ◽  
Tomáš Radovnický ◽  
Daniel Adámek ◽  
Jaroslav Hron ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Anterior Communicating Artery ◽  
Rupture Risk ◽  
Anterior Communicating Artery Aneurysm ◽  
Computational Fluid Dynamics Cfd ◽  
Inflow Jet ◽  
Rupture Site

AbstractComputational fluid dynamics (CFD) has been studied as a tool for the stratification of aneurysm rupture risk. We performed CFD analysis in a patient operated on for a ruptured anterior communicating artery aneurysm. The point of rupture was identified during surgery. The aneurysm and blood vessels were segmented from computed tomography angiography to prepare a model for simulations. We found that the streamlines showed a concentrated inflow jet directed straight at the rupture point, and high wall shear stress was found at the point of rupture in the aneurysm sac. Thus specific local hemodynamics may be indicative of the aneurysm rupture site.

scholarly journals Early Rebleeding of Small Anterior Communicating Artery Aneurysm with Presumed Extrusion of Coil Loop to outside the Aneurysmal Wall during Endovascular Treatment

2009 ◽  
Vol 15 (1) ◽  
pp. 103-108 ◽  
Author(s):  
HW Pyun ◽  
DK Hyun ◽  
DH Lee ◽  
SW Park ◽  
MK Lim
Keyword(s):  
Endovascular Treatment ◽  
Coil Embolization ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Surgical Clipping ◽  
Aneurysmal Wall ◽  
Follow Up Study ◽  
Complete Treatment ◽  
Anterior Communicating Aneurysm

Although endovascular treatment has been proved to be as effective as surgical clipping in the prevention of rebleeding of ruptured aneurysm, early rebleeding after coil embolization has seldom been reported. We experienced early re-hemorrhage in two patients of ruptured small anterior communicating artery aneurysms of complete treatment with coil-embolization initially. In both cases what interested us was not early rebleeding itself but how the presumed extrusion of the first part of coil loop beyond aneurysmal wall developed. However, there was no evidence of intraprocedural rupture and moreover complete occlusion with only one or two coils was obtained. Our two patients underwent successful second treatment. We discovered the presumed extruded first part of the coil loop initially was located inside the enlarged aneurysmal sac in retreatment stage. In case of coil embolization of ruptured small anterior communicating aneurysm, the phenomenon we experienced with no evidence of intraprocedural rupture in spite of obvious extrusion of coil loop beyond the aneurysmal wall can be a sign of necessity for early follow-up study including plain radiography to track the change in the presumed extruded coil loop.

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