Penetration of the optic chiasm by a ruptured anterior communicating artery aneurysm

1997 ◽  
Vol 87 (2) ◽  
pp. 324-326 ◽  
Author(s):  
Isao Date ◽  
Tatsuro Akioka ◽  
akashi Ohmoto
Keyword(s):  
Optic Tract ◽  
Artery Aneurysm ◽  
Optic Chiasm ◽  
Visual Disturbance ◽  
Abrupt Onset ◽  
Anterior Communicating Artery ◽  
Content Type ◽  
Anterior Communicating Artery Aneurysm ◽  
Finger Counting ◽  
The Right

✓ There are few reports of anterior communicating artery aneurysms causing visual symptoms, and penetration of the optic chiasm by such aneurysms has not been reported. A 40-year-old man presented with the abrupt onset of left homonymous hemianopsia, right visual acuity disturbance (finger counting), and slight headache. Angiography disclosed a 7-mm anterior communicating artery aneurysm projecting inferiorly. After the neck of the aneurysm was clipped, the dome of the aneurysm was resected. The operation confirmed that the aneurysm had penetrated the right half of the optic chiasm and the thrombosed dome had also compressed the right optic tract. Although the aneurysm was successfully clipped, the visual disturbance persisted after surgery, suggesting that the damage to the visual pathways by aneurysm penetration was irreversible in this case.

Unusual intercarotid anastomosis associated with anterior communicating artery aneurysm

1987 ◽  
Vol 67 (5) ◽  
pp. 765-767 ◽  
Author(s):  
Patrick T. Tracy
Keyword(s):  
Carotid Arteries ◽  
Internal Carotid ◽  
Anterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Content Type ◽  
Anterior Communicating Artery Aneurysm ◽  
The Right ◽  
Internal Carotid Arteries ◽  
Angiographic Findings

✓ The case is presented of a 34-year-old man with subarachnoid hemorrhage from rupture of an anterior communicating artery aneurysm. The magnetic resonance imaging and angiographic findings are reported. Angiography showed the aneurysm plus an unusual anastomosis between the intracavernous portions of both internal carotid arteries. The anastomosis crossed posterior to the base of the dorsum sellae and was associated with absence of the right internal carotid artery and the A1 segment of the right anterior cerebral artery. This is the 11th case of such an unusual intercarotid anastomosis reported in the literature.

Microsurgical anatomy of the anterior cerebral-anterior communicating-recurrent artery complex

1976 ◽  
Vol 45 (3) ◽  
pp. 259-272 ◽  
Author(s):  
David Perlmutter ◽  
Albert L. Rhoton
Keyword(s):  
Optic Tract ◽  
Cerebral Aneurysms ◽  
Optic Chiasm ◽  
Anterior Communicating Artery ◽  
Microsurgical Anatomy ◽  
Content Type ◽  
Proximal Half ◽  
Clinical Consequences ◽  
The Right ◽  
Perforating Arteries

✓ The microvascular relationships important to surgery of aneurysms in the anterior communicating region were defined in 50 cadaver brains. The recurrent artery of Heubner was frequently exposed before the A-1 segment in defining the neck on anterior cerebral aneurysms because it commonly courses anterior to A-1. It arose from the A-2 segment of the anterior cerebral artery (ACA) in 78% and most commonly terminated in the area of the anterior perforated substance, and lateral to it in the Sylvian fissure. The anterior communicating artery (ACoA) frequently gave rise to perforating arteries which terminated in the superior surface of the optic chiasm and above the chiasm in the anterior hypothalamus. This finding contrasts with previous reports that no perforating branches arise from the communicating artery. The proximal half of the A-1 segment was a richer source of perforating arteries than the distal half. The A-1 branches most commonly terminated in the anterior perforated substance, the optic chiasm, and the region of the optic tract. The ACoA increased in size as the difference in the diameter between the right and left A-1 segments increased. Frequent variants such as double or triple ACoA's, triple A-2 segments, and duplication of the A-1 segments were encountered. The clinical consequences of occlusion of the recurrent artery and of the perforators from the ACoA and medial and lateral segment of A-1 are reviewed.

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.

scholarly journals Partial thrombosis of an anterior communicating artery aneurysm prior to endovascular coiling, with intra-procedural distal thrombus embolization

2017 ◽  
Vol 23 (6) ◽  
pp. 589-593 ◽  
Author(s):  
Will Guest ◽  
Dipanka Sarma ◽  
Thomas Marotta
Keyword(s):  
Rare Event ◽  
Artery Aneurysm ◽  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Time Interval ◽  
Thromboembolic Stroke ◽  
Anterior Communicating Artery Aneurysm ◽  
The Right ◽  
Partial Thrombosis ◽  
Intracranial Circulation

Thromboembolic stroke from migration of thrombus formed in non-giant intracranial aneurysms is a recognized but rare event. We describe a case of partial thrombosis of a 7 mm anterior communicating artery aneurysm, which embolized to the right callosomarginal artery in the brief time interval between two sequential diagnostic angiograms performed as part of elective endovascular coiling, and before any instrumentation had been advanced into the intracranial circulation. To our knowledge, this is the first reported case of aneurysmal thrombus embolization observed angiographically in near real time.

scholarly journals Junctional Chiasmatic Syndrome Due to Large Anterior Communicating Artery Aneurysm

2017 ◽  
Vol 08 (03) ◽  
pp. 455-457
Author(s):  
Maruthi Kesani ◽  
Pavan Kumar Pelluru ◽  
Suchanda Bhattacharjee ◽  
Rajesh Alugolu ◽  
A. K. Purohit
Keyword(s):  
Clinical Practice ◽  
Optic Nerve ◽  
Visual Loss ◽  
Artery Aneurysm ◽  
Optic Chiasm ◽  
Anterior Communicating Artery ◽  
Anterior Communicating Artery Aneurysm

ABSTRACTEven though aneurysm involving the anterior communicating artery (A Com A) was common in clinical practice, producing compressive symptoms such as visual loss was rare. We report a case, in which patient had gradually progressive visual loss with features of the junctional chiasmatic syndrome, imaging revealed partially thrombosed large A Com A aneurysm. Intraoperatively, aneurysm was found compressing the optic chiasm and right optic nerve, following clipping and decompression of the optic nerve and chiasm there was gradually improvement in the vision over 2 weeks postoperatively.

Early aneurysm recurrence after technically satisfactory Guglielmi detachable coil therapy: is early surveillance needed?

2000 ◽  
Vol 92 (2) ◽  
pp. 355-358 ◽  
Author(s):  
A. Shahram Makoui ◽  
Donald A. Smith ◽  
Avery J. Evans ◽  
David W. Cahill
Keyword(s):  
High Risk ◽  
Artery Aneurysm ◽  
Primary Treatment ◽  
Anterior Communicating Artery ◽  
Detachable Coil ◽  
Content Type ◽  
Anterior Communicating Artery Aneurysm ◽  
Guglielmi Detachable Coil ◽  
Control Angiography ◽  
Fine Print

✓ Guglielmi detachable coil (GDC) therapy was initially intended as a treatment for select patients harboring aneurysms deemed to be at high risk for clip ligation. As experience with the technique has grown, many centers are now offering GDC therapy as a primary treatment to patients who are also good surgical candidates. The authors report a case in which a ruptured anterior communicating artery aneurysm recurred within 2 weeks of a technically satisfactory GDC procedure. The patient subsequently underwent successful surgery for clip ligation of the lesion. This is the earliest reported recurrence of an aneurysm after angiographically confirmed successful GDC therapy and underscores the need for performing early control angiography in patients undergoing this procedure.

Giant Anterior Communicating Artery Aneurysm with Bitemporal Hemianopsia

Neurosurgery ◽  
1981 ◽  
Vol 8 (6) ◽  
pp. 703-706 ◽  
Author(s):  
Else Højer-Pedersen ◽  
Jens Haase
Keyword(s):  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Optic Chiasm ◽  
Anterior Communicating Artery ◽  
Mechanical Pressure ◽  
Anterior Communicating Artery Aneurysm ◽  
Visual Defects ◽  
Operative Findings

abstract Giant aneurysm of the anterior communicating artery producing bitemporal hemianopsia is extremely rare. A case is presented and the literature is reviewed. The operative findings support the hypothesis that the visual defects are caused by mechanical pressure on the optic chiasm.

Traumatic middle meningeal arteriovenous fistula caused by three-point skull fixation

1984 ◽  
Vol 60 (4) ◽  
pp. 853-855 ◽  
Author(s):  
Tetsuji Inagawa ◽  
Tetsuji Takeda ◽  
Haruyoshi Taguchi ◽  
Kazuko Kamiya ◽  
Tohru Yamada
Keyword(s):  
Head Injury ◽  
Arteriovenous Fistula ◽  
Unusual Case ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Content Type ◽  
Av Fistula ◽  
Anterior Communicating Artery Aneurysm ◽  
Av Fistulas ◽  
Fine Print

✓ Traumatic middle meningeal arteriovenous (AV) fistulas usually occur as rare complications of head injury. An unusual case of a middle meningeal AV fistula is presented which resulted from three-point fixation with a skull clamp to stabilize the head during surgery for an anterior communicating artery aneurysm.

Thrombolysis and Mechanical Fragmentation to Treat Massive Pulmonary Embolism in a Patient with an Anterior Communicating Artery Aneurysm

2003 ◽  
Vol 10 (2) ◽  
pp. 332-335 ◽  
Author(s):  
Ramazan Kutlu ◽  
Alpay Alkan ◽  
Ayhan Kocak ◽  
Kaya Sarac
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Arteries ◽  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Recombinant Tissue Plasminogen Activator ◽  
Massive Pulmonary Embolism ◽  
Anterior Communicating Artery ◽  
Anterior Communicating Artery Aneurysm ◽  
The Right ◽  
Mechanical Fragmentation

Purpose: To describe successful management of massive pulmonary embolism suffered by a patient with an unsecured intracranial aneurysm. Case Report: An anterior communicating artery aneurysm was found 10 days after a 50-year-old woman was admitted to the intensive care unit with subarachnoid hemorrhage. The patient developed severe acute dyspnea before planned surgery; imaging demonstrated thrombus in the right and left pulmonary arteries. Heparin was contraindicated, so an emergent coil embolization procedure was undertaken. In the same session, recombinant tissue plasminogen activator was administered directly into the thrombus. After 2 hours of thrombolysis and intermittent mechanical fragmentation, lung perfusion improved, and the patient's symptoms abated. Conclusions: Mechanical fragmentation together with fibrinolytic agent administration is a safe and effective treatment for pulmonary embolism after securing cerebral aneurysms.

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