An Aneurysm Developing on the Infundibulum of Posterior Communicating Artery : Case Report and Literature Review

  • Jang, Woo-Youl (Department of Neurosurgery, Chonnam National University, Medical School) ;
  • Joo, Sung-Pil (Department of Neurosurgery, Chonnam National University, Medical School) ;
  • Kim, Tae-Sun (Department of Neurosurgery, Chonnam National University, Medical School) ;
  • Kim, Jae-Hyoo (Department of Neurosurgery, Chonnam National University, Medical School)
  • Published : 2006.10.30

Abstract

Infundibular dilatation is funnel-shaped symmetrical enlargement that occurs at the origin of cerebral arteries and which is apparent on 7 to 25% of normal angiograms. Infundibular dilatation is frequently considered a normal anatomic variation of no pathologic significance. The authors report a case in which an aneurysm developed on an infundibular dilatation of the posterior communicating artery [PComA]. A 72-year-old woman presented with severe headache, nausea, and vomiting. Digital subtraction angiography showed a saccular aneurysm arising from the origin of the left PComA. Operative findings revealed the aneurysm and infundibular widening of the right PComA. The aneurysm was successfully obliterated. Whether infundibular dilatation is a pre-aneurysmal state or a benign dilatation is controversial. However, we believe infundibular dilatation of the PComA in this case may have served as a pre-aneurysmal lesion.

Keywords

References

  1. Allcock JM, Canham PB : angiographic study of the growth of intracranial aneurysms. J Neurosurg 45 : 617-621, 1976 https://doi.org/10.3171/jns.1976.45.6.0617
  2. Bjorkesten G, Troupp H : Changes in the size of intracranial aneurysms. J Neurosurg 19 : 583-588, 1962 https://doi.org/10.3171/jns.1962.19.7.0583
  3. Ebstein F, Ransohoff J : The significance of junctional dilatation of the posterior communicating artery. J Neurosurg 33 : 529-531, 1970 https://doi.org/10.3171/jns.1970.33.5.0529
  4. Endo S, Furuichi S, Takaba M, Hirashima Y, Nishijima M, Takaku A : Clinical study of enlarged infundibular dilatation of the origin of the posterior communicating artery. J Neurosurg 83 : 421-425, 1995 https://doi.org/10.3171/jns.1995.83.3.0421
  5. Fox JL, Baiz TC, Jakoby RK : Differentiation of aneurysm from infundibulum of the posterior communicating artery. J Neurosurg 21 : 135-138, 1964 https://doi.org/10.3171/jns.1964.21.2.0135
  6. Hassler O, Salzmann GF : Angiographic and Histologic changes in infundibular widening of the Posterior Communicating Artery. ActaRadiol Diagn (Stockh) 1 : 321-327, 1963
  7. Itakura T, Ozaki F, Nakai E, Fuji T, Hayashi S, Komai N : Bilateral aneurysm formation developing from junctional dilatation (infundibulum) of the posterior communicating artery : Case report. J Neurosurg 58 : 117-119, 1983 https://doi.org/10.3171/jns.1983.58.1.0117
  8. Kang SD : True posterior communicating artery aneurysm. J Korean Neurosurg Soc 26 : 1007-1010, 1997
  9. Kawanishi M, Sakaguchi I, Miyake H : Occlusion of the posterior communicating artery mimicking cerebral aneurysms : Case report. Neurolo Res 25 : 543-545, 2003 https://doi.org/10.1179/016164103101201805
  10. Marshman LA, Ward PJ, Walter PH, Dossetor RS : The Progression of an Infundibulum to Aneurysm Formation and Rupture : Case Report and Literature Review. Neurosurgery 43 : 1445-1449, 1998 https://doi.org/10.1097/00006123-199812000-00107
  11. Ohkuma H, Ebina K, Iwabuchi : Angiographic Study on Infundibular Dilatation of the Posterior Communicating Artery. Neurol Med Chir (Tokyo) 25 : 907-914, 1985 https://doi.org/10.2176/nmc.25.907
  12. Patrick D, Appleby A : Infundibular widening of the posterior communicating artery progressing to true aneurysm. British Journal of Radiology 56 : 59-60, 1983 https://doi.org/10.1259/0007-1285-56-661-59
  13. Patrick D, Appleby A : Familial intracranial aneurysm and infundibular widening. Neuroradiology 25 : 329-334, 1983 https://doi.org/10.1007/BF00439213
  14. Stuntz JT, Ojemann GA, Alvord EC : Radiographic and histological demonstration of an aneurysm developing on the infundibulum of the posterior communicating artery. J Neurosurg 33 : 591-595, 1970 https://doi.org/10.3171/jns.1970.33.5.0591
  15. Waga S, Morikawa A : Aneurysm Developing on the Infundibular Widening of the Posterior Communicating Artery. Surg Neurol 11 : 125-127, 1979
  16. Yoshida M, Anegawa S, Moritaka K : Significance of Infundibular Dilatation in Unexplained Subarachnoid Hemorrhage. Neurosurgery 9 : 718-721, 1981 https://doi.org/10.1227/00006123-198112000-00018
  17. Yoshimoto T, Suzuki J : Surgical treatment of an aneurysm on the funnel-shaped bulge of the posterior communicating artery. J Neurosurg 41 : 377-379, 1974 https://doi.org/10.3171/jns.1974.41.3.0377
  18. Young B, Meacham F, Allen JH : Documented enlargement and rupture of a small arterial sacculation : Case report. J Neurosurg 34 : 814-817, 1971 https://doi.org/10.3171/jns.1971.34.6.0814