Subarachnoid hemorrhage from a ruptured anterior cerebral artery aneurysm caused by polyarteritis nodosa

✓ Polyarteritis nodosa (PAN) is a rare systemic necrotizing arteritis that involves small- and medium-sized arteries in various organs. Although aneurysm formation in visceral arteries is a typical finding in PAN, intracranial aneurysms are much less common, and only a few cases of aneurysm rupture associated with this disease have been documented. In this paper, the authors report on a ruptured PAN aneurysm of the anterior cerebral artery; the lesion was trapped and resected. On histological examination, extensive fibrinoid necrosis and an inflammatory infiltration of leukocytes were seen in the aneurysm wall. To the authors' knowledge this is the first report of subarachnoid hemorrhage from a histologically confirmed PAN aneurysm.

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

World Neurosurgery ◽

10.1016/j.wneu.2018.10.086 ◽

2019 ◽

Vol 122 ◽

pp. e480-e486 ◽

Cited By ~ 3

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

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Pediatric Moyamoya Presenting as a Subarachnoid Hemorrhage from a Ruptured Anterior Cerebral Artery Aneurysm

World Neurosurgery ◽

10.1016/j.wneu.2019.10.157 ◽

2020 ◽

Vol 134 ◽

pp. 123-127 ◽

Cited By ~ 2

Author(s):

Mohammad Hassan A. Noureldine ◽

Ibrahim Saikali ◽

Anis Nassif ◽

Rita Chahinian ◽

Ahmad Sweid ◽

...

Keyword(s):

Subarachnoid Hemorrhage ◽

Cerebral Artery ◽

Anterior Cerebral Artery ◽

Artery Aneurysm ◽

Anterior Cerebral Artery Aneurysm ◽

Cerebral Artery Aneurysm

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Aneurysmal subarachnoid hemorrhage in a patient with bilateral A1 fenestrations associated with an azygos anterior cerebral artery

Journal of Neurosurgery ◽

10.3171/jns.1996.84.4.0681 ◽

1996 ◽

Vol 84 (4) ◽

pp. 681-684 ◽

Cited By ~ 42

Author(s):

Robert M. Friedlander ◽

Christopher S. Ogilvy

Keyword(s):

Subarachnoid Hemorrhage ◽

Cerebral Artery ◽

Anterior Cerebral Artery ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Vascular Anatomy ◽

Vascular Anomaly ◽

Rare Occurrence ◽

Content Type ◽

Proximal Anterior Cerebral Artery ◽

Current Article

✓ Fenestration of the proximal anterior cerebral artery (A1 segment) is a rare occurrence. This vascular anomaly is often associated with aneurysms and other abnormalities. The current article describes the case of a 33-year-old man who presented with a subarachnoid hemorrhage secondary to a ruptured aneurysm originating from the proximal end of an A1 fenestration. This patient also had a contralateral A1 fenestration as well as an azygos anterior cerebral artery. This is the first report of such an unusual vascular anatomy. The literature is reviewed and possible embryological mechanisms are discussed.

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Interoptic course of the anterior cerebral artery associated with anterior cerebral artery aneurysm

Journal of Neurosurgery ◽

10.3171/jns.1982.56.2.0302 ◽

1982 ◽

Vol 56 (2) ◽

pp. 302-304 ◽

Cited By ~ 27

Author(s):

Howard J. Senter ◽

Daniel J. Miller

Keyword(s):

Carotid Artery ◽

Cerebral Artery ◽

Anterior Cerebral Artery ◽

Artery Aneurysm ◽

Optic Nerves ◽

Content Type ◽

Anterior Cerebral Artery Aneurysm ◽

Cerebral Artery Aneurysm ◽

Fine Print

✓ A ruptured anterior cerebral artery aneurysm is reported in a patient in whom a solitary anterior cerebral artery arose from the proximal carotid artery and ascended between the optic nerves.

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Hemispheric disconnection syndrome persisting after anterior cerebral artery aneurysm rupture

Neurosurgery ◽

10.1097/00006123-198712000-00008 ◽

1987 ◽

Vol 21 (6) ◽

pp. 831???8

Author(s):

H S Levin ◽

F C Goldstein ◽

S Y Ghostine ◽

R L Weiner ◽

M J Crofford ◽

...

Keyword(s):

Cerebral Artery ◽

Anterior Cerebral Artery ◽

Artery Aneurysm ◽

Aneurysm Rupture ◽

Disconnection Syndrome ◽

Anterior Cerebral Artery Aneurysm ◽

Cerebral Artery Aneurysm

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The role of anatomical anomalies in anterior communicating artery aneurysm rupture

ARS Medica Tomitana ◽

10.2478/arsm-2013-0026 ◽

2013 ◽

Vol 19 (3) ◽

pp. 147-153

Author(s):

Cr.P Dimitriu ◽

C. Ionescu ◽

P. Bordei ◽

I. Bulbuc

Keyword(s):

Cerebral Artery ◽

Anterior Cerebral Artery ◽

Cerebral Aneurysms ◽

Artery Aneurysm ◽

Aneurysm Rupture ◽

Circle Of Willis ◽

Control Group ◽

Anterior Communicating Artery ◽

Aneurysm Size ◽

Proper Patient Selection

Abstract Background and purpose:limited data exist to guide proper patient selection for preventive treatment of unruptured cerebral aneurysms. Cerebral aneurysms have been associated with anomalies of arterial segments that are forming the brain arterial circle of Willis but whether this association is also related to aneurysm rupture is not known. The occurrence of cerebral aneurysm rupture when a circle of Willis anomaly was present or absent was compared. Material and methods: we have performed this study on a number of 312 cases, of which 87 were dissections, 22 dissection followed by plastic injection, 135 magnetic resonance angiography (MRA), 75 computer tomography angiography (CTA), 40 digital subtraction angiographies (DSA), 30 in vivo (intraoperatory) observation. Brain vascular imaging was reviewed for aneurysm size, morphology and presence of anterior cerebral artery anomalies. Results: we divided the study group in 2 cohorts, one control group of 272 cases, in which we have study the anatomical variants occurrence and aneurysm occurrence in general population and another included 45 patients admitted thru emergency room for subarachnoid hemorrhage, of those 38 were ruptured aneurysm of anterior communicating artery (ACoA). Mean aneurysm size was 8.9 mm. An anterior cerebral artery anomaly was identified in 31 cases (81.5%). Multivariate analysis revealed a higher risk of aneurysm rupture when an anterior cerebral artery was present. Conclusions: this study shows that anterior cerebral artery anomalies are more commonly found in ruptured as opposed to unruptured ACoA aneurysms. The presence of an ACA anomaly may be an important characteristic for selecting patients for preventive aneurysm treatment.

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Paradoxical aggravation of vasospasm with papaverine infusion following aneurysmal subarachnoid hemorrhage

Journal of Neurosurgery ◽

10.3171/jns.1996.84.4.0690 ◽

1996 ◽

Vol 84 (4) ◽

pp. 690-695 ◽

Cited By ~ 46

Author(s):

Brent L. Clyde ◽

Andrew D. Firlik ◽

Anthony M. Kaufmann ◽

MichaelP. Spearman ◽

Howard Yonas

Keyword(s):

Subarachnoid Hemorrhage ◽

Cerebral Artery ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Artery Aneurysm ◽

Anterior Communicating Artery ◽

Left Middle Cerebral Artery ◽

Xenon Ct ◽

Content Type ◽

Symptomatic Vasospasm ◽

Fine Print

✓ Reports of intraarterial papaverine infusion as treatment for cerebral vasospasm are few and documented complications are uncommon. The authors report the case of a patient with paradoxical aggravation of cerebral arterial narrowing during selective intraarterial papaverine infusion intended to treat vasospasm following aneurysmal subarachnoid hemorrhage (SAH). A 48-year-old man presented to the authors' service with symptomatic vasospasm 10 days after experiencing an SAH. The ruptured anterior communicating artery aneurysm was surgically obliterated the following day, and thereafter maximum hypervolemic and hypertensive therapies were used. However, the patient remained lethargic, and a stable xenon—computerized tomography (CT) cerebral blood flow (CBF) study revealed CBF to be 15 cc/100 g/minute in the left anterior cerebral artery (ACA) and 25 cc/100 g/minute in the right ACA territories. Cerebral arteriography demonstrated diffuse severe left ACA and mild left middle cerebral artery (MCA) vasospasm. In response intraarterial papaverine was infused into the internal carotid artery just proximal to the ophthalmic artery. During the infusion the patient became aphasic and exhibited right hemiplegia. Arteriography performed immediately after the intraarterial papaverine infusion revealed diffuse exacerbation of vasospasm in the distal ACA and MCA territories. A repeat xenon—CT CBF study showed that CBF in the left ACA and the MCA had drastically decreased (2 cc/100 g/minute and 10 cc/100 g/minute, respectively). Despite aggressive management, infarction ultimately developed. This is the first clinical case to illustrate a paradoxical effect of intraarterial papaverine treatment for vasospasm following aneurysmal SAH. The possible mechanisms of this paradoxical response and potential therapeutic reactions are reviewed.

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Giant thrombosed aneurysm associated with an arteriovenous malformation

Journal of Neurosurgery ◽

10.3171/jns.1978.49.2.0278 ◽

1978 ◽

Vol 49 (2) ◽

pp. 278-282 ◽

Cited By ~ 24

Author(s):

Bizhan Aarabi ◽

John Chambers

Keyword(s):

Arteriovenous Malformation ◽

Cerebral Artery ◽

Anterior Cerebral Artery ◽

Artery Aneurysm ◽

Content Type ◽

Thrombosed Aneurysm ◽

Anterior Cerebral Artery Aneurysm ◽

Cerebral Artery Aneurysm ◽

Fine Print

✓ The authors describe a case of giant anterior cerebral artery aneurysm associated with an anatomically related arteriovenous malformation (AVM). The aneurysm was almost completely thrombosed and was resected along with the AVM.

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