Glue Embolization of Ruptured Anterior Thalamoperforating Artery Aneurysm in Patient with Both Internal Carotid Arteries Occlusion.
10.3340/jkns.2011.49.5.287
- Author:
Jae Il LEE
1
;
Chang Hwa CHOI
;
Jun Kyeung KO
;
Tae Hong LEE
Author Information
1. Department of Neurosurgery, School of Medicine, Pusan National University Hospital, Busan, Korea. chwachoi@pusan.ac.kr
- Publication Type:Case Report
- Keywords:
Anterior thalamoperforating artery;
Aneurysm;
Glue embolization
- MeSH:
Adhesives;
Aged;
Aneurysm;
Arteries;
Basal Ganglia;
Brain;
Carotid Artery, Internal;
Cerebral Hemorrhage;
Consciousness;
Female;
Glasgow Coma Scale;
Globus Pallidus;
Headache;
Hemorrhage;
Humans;
Neurologic Manifestations;
Subarachnoid Hemorrhage;
Surgical Instruments;
Unconsciousness
- From:Journal of Korean Neurosurgical Society
2011;49(5):287-289
- CountryRepublic of Korea
- Language:English
-
Abstract:
Thalamoperforating artery aneurysms are rarely reported in the literature. We report an extremely rare case of ruptured distal anterior thalamoperforating artery aneurysm which was treated by endovascular obliteration in a patient with occlusion of both the internal carotid arteries (ICAs) : A 72-year-old woman presented with severe headache and loss of consciousness. Initial level of consciousness at the time of admission was drowsy and the Glasgow Coma Scale score was 14. Brain computed tomography (CT) scan was performed which revealed intracerebral hemorrhage in right basal ganglia, subarachnoid hemorrhage, and intraventricular hemorrhage. The location of the aneurysm was identified as within the globus pallidus on CT angiogram. Conventional cerebral angiogram demonstrated occlusion of both the ICAs just distal to the fetal type of posterior communicating artery and the aneurysm was arising from right anterior thalamoperforating artery (ATPA). A microcatheter was navigated into ATPA and the ATPA proximal to aneurysm was embolized with 20% glue. Post-procedural ICA angiogram demonstrated no contrast filling of the aneurysm sac. The patient was discharged without any neurologic deficit. Endovascular treatment of ATPA aneurysm is probably a more feasible and safe treatment modality than surgical clipping because of the deep seated location of aneurysm and the possibility of brain retraction injury during surgical operation.
