DOI QR코드

DOI QR Code

Ruptured mirror DACA aneurysm: A rare case report and review of literature

  • Deepak Kumar Singh (Department of Neurosurgery, DR. Ram Manohar Lohia Institute of Medical Sciences) ;
  • Prevesh Kumar Sharma (Department of Neurosurgery, DR. Ram Manohar Lohia Institute of Medical Sciences) ;
  • Arun Kumar Singh (Department of Neurosurgery, DR. Ram Manohar Lohia Institute of Medical Sciences) ;
  • Vipin Kumar Chand (Department of Neurosurgery, DR. Ram Manohar Lohia Institute of Medical Sciences)
  • Received : 2022.07.10
  • Accepted : 2022.11.07
  • Published : 2023.09.30

Abstract

Bilateral distal anterior cerebral artery (DACA) aneurysms also called "kissing aneurysms" or "mirror aneurysm" are extremely rare, accounting for only 0.2% of all intracranial aneurysms. There have only been a few examples of mirror DACA aneurysms reported in the literature. Here, we report a rare case of mirror DACA aneurysm in a middle aged female with its successful clipping. Patient was admitted with severe headache and altered sensorium. Computed tomography (CT) head was suggestive of anterior inter-hemispheric hematoma. Digital subtraction angiography (DSA) was done which was suggestive of two distal anterior cerebral artery aneurysms located at same anatomical position. It was treated through microsurgical clipping. Mirror image DACA aneurysms are rare occurrence. All patients with ruptured DACA aneurysms should have angiography with 3D reconstruction studies. This aids in determining the aneurysm's morphology and planning treatment accordingly.

Keywords

References

  1. Alimohammadi M, Bidabadi MS, Amirjamshidi A. Bilateral "kissing" aneurysms of the distal pericallosal arteries: report of a case and review of the literature. Neurosurg Q. 2010;20(4):308-10. https://doi.org/10.1097/WNQ.0b013e31820113fe
  2. Baldawa SS, Menon G, Nair S. Kissing anterior communicating artery aneurysms: diagnostic dilemma and management issues. J Postgrad Med. 2011 Jan-Mar;57(1):44-7. https://doi.org/10.4103/0022-3859.74288
  3. Baptista AG. Studies on the arteries of the brain. II. The anterior cerebral artery: some anatomic features and their clinical implications. Neurology. 1963 Oct;13:825-35. https://doi.org/10.1212/WNL.13.10.825
  4. Beck J, Rohde S, Berkefeld J, Seifert V, Raabe A. Size and location of ruptured and unruptured intracranial aneurysms measured by 3-dimensional rotational angiography. Surg Neurol. 2006 Jan;65(1):18-25; discussion 25-7. https://doi.org/10.1016/j.surneu.2005.05.019
  5. Choque-Velasquez J, Hernesniemi J. One burr-hole craniotomy: anterior inerhemispheric approach in Helsinki neurosurgery. Surg Neurol Int. 2018 Jul;9:141.
  6. Forget TR, Benitez R, Veznedaroglu E, Sharan A, Mitchell W, Silva M, et al. A review of size and location of ruptured intracranial aneurysms. Neurosurgery. 2001 Dec;49(6):1322-5; discussion 1325-6. https://doi.org/10.1097/00006123-200112000-00006
  7. Harada K, Orita T, Ueda Y. Large kissing aneurysms of the middle cerebral artery: a case report-classification of kissing aneurysms. No Shinkei Geka. 2004 May;32(5):513-7.
  8. Hernesniemi J, Tapaninaho A, Vapalahti M, Niskanen M, Kari A, Luukkonen M. Saccular aneurysms of the distal anterior cerebral artery and its branches. Neurosurgery. 1992 Dec;31(6):994-8; discussion 998-9. https://doi.org/10.1227/00006123-199212000-00002
  9. Huang Q, Shen J, Xu Y, Liu J. Endovascular treatment of ruptured distal anterior cerebral artery aneurysm. Neurol India. 2010 Mar-Apr;58(2):259-63. https://doi.org/10.4103/0028-3886.63809
  10. International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms - risk of rupture and risks of surgical intervention. N Engl J Med. 1998 Dec;339(24):1725-33. https://doi.org/10.1056/NEJM199812103392401
  11. Jefferson A. The significance for diagnosis and for surgical technique of multiple aneurysms of the same internal carotid artery. Acta Neurochir (Wien). 1978;41(1-3):23-37. https://doi.org/10.1007/BF01809134
  12. Juvela S, Porras M, Heiskanen O. Natural history of unruptured intracranial aneurysms: a long-term follow-up study. J Neurosurg. 1993 Aug;79(2):174-82. https://doi.org/10.3171/jns.1993.79.2.0174
  13. Komiyama M, Yasui T, Tamura K, Nagata Y, Fu Y, Yagura H. "Kissing aneurysms" of the internal carotid artery. Neurol Med Chir (Tokyo). 1994 Jun;34(6):360-4. https://doi.org/10.2176/nmc.34.360
  14. Kozyrev D, Jahromi B, Thiarawat P, Choque-Velasquez J, Ludtka C, Goehre F, et al. Three distal anterior cerebral artery aneurysms in the same branch associated with five additional intracranial aneurysms. Surg Neurol Int. 2017 Apr;8:62.
  15. Lehecka M, Dashti R, Lehto H, Kivisaari R, Niemela M, Hernesniemi J. Distal anterior cerebral artery aneurysms. Acta Neurochir Suppl. 2010;107:15-26. https://doi.org/10.1007/978-3-211-99373-6_3
  16. Leheka M, Lehto H, Niemela M, Juvela S, Dashti R, Koivisto T, et al. Distal anterior cerebral artery aneurysms: treatment and outcome analysis of 501 patients. Neurosurgery. 2008 Mar;62(3):590-601; discussion 590-601. https://doi.org/10.1227/01.neu.0000317307.16332.03
  17. Ohashi Y, Horikoshi T, Sugita M, Yagishita T, Nukui H. Size of cerebral aneurysms and related factors in patients with subarachnoid hemorrhage. Surg Neurol. 2004 Mar;61(3):239-45; discussion 245-7. https://doi.org/10.1016/S0090-3019(03)00427-0
  18. Ohno K, Monma S, Suzuki R, Masaoka H, Matsushima Y, Hirakawa K. Saccular aneurysms of the distal anterior cerebral artery. Neurosurgery. 1990 Dec;27(6):907-12; discussion 912-3. https://doi.org/10.1227/00006123-199012000-00008
  19. Pandey A, Rosenwasser RH, Veznedaroglu E. Management of distal anterior artery ameurysms: a single institution retrospective analysis (1997-2005). Neurosurgery 2007 Nov;61(5):909-16; discussion 916-7. https://doi.org/10.1227/01.neu.0000303186.26684.81
  20. Sekerci Z, Sanli M, Ergun R, Oral N. Aneurysms of the distal anterior cerebral artery: a clinical series. Neurol Neurochir Pol. 2011 Mar-Apr;45(2):115-20. https://doi.org/10.1016/S0028-3843(14)60021-9
  21. Sonobe M, Yamazaki T, Yonekura M, Kikuchi H. Small unruptured intracranial aneurysm verification study: SUAVe study, Japan. Stroke. 2010 Sep;41(9):1969-77. https://doi.org/10.1161/STROKEAHA.110.585059
  22. Sturiale CL, Brinjikji W, Murad MH, Cloft HJ, Kallmes DF, Lanzino G. Endovascular treatment of distal anterior cerebral artery aneurysms: single-center experience and a systematic review. AJNR Am J Neuroradiol. 2013 Dec;34(12):2317-20. https://doi.org/10.3174/ajnr.A3629
  23. Suh SJ, Kang DG, Ryu KY, Cho JH. Endovascular treatment of 'kissing aneurysms' at the anterior communicating artery. J Korean Neurosurg Soc. 2008 Sep;44(3):163-5. https://doi.org/10.3340/jkns.2008.44.3.163
  24. Sun Z, Wu C, Wang F, Xue Z, Xu B, Zhou D. Surgical management of intracranial mirror aneurysms. Zhonghua Wai Ke Za Zhi. 2013 Oct;51(10):912-5.
  25. Suzuki K, Yatomi K, Yamamoto M, Oishi H, Arai H. Endovascular therapy of distal anterior cerebral artery aneurysms: single-institution clinical experience with 47 patients (49 aneurysms). Journal of Neuroendovascular Therapy. 2019;13:329-35. https://doi.org/10.5797/jnet.oa.2019-0004
  26. Yasargil MG, Carter LP. Saccular aneurysms of the distal anterior cerebral artery. J Neurosurg. 1974 Feb;40(2):218-23. https://doi.org/10.3171/jns.1974.40.2.0218
  27. Yasargil MG. Microneurosurgery, in Clinical Considerations, Surgery of the Intracranial Aneurysms and Results (Microsurgical Anatomy of the Basal Cisterns & Vessels of Brain). Vol. 2. New York, NY: Thieme, 1984. p. 33-123.
  28. Yasargil MG. Surgery of the Intracranial Aneurysms and Results. Microneurosurgery, Vol. II. Clinical Considerations. Stuttgart: George Thieme, 1984. p. 224-31.