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57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

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Endovascular surgery for true posterior communicating artery aneurysm: Report of two cases

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  • corresponding author T. Higa - Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan
  • H. Kizuki - Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan
  • H. Arai - Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan
  • K. Kurosawa - Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan
  • T. Hori - Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 09.140

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc357.shtml

Published: May 8, 2006

© 2006 Higa et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Aneurysms of the posterior communicating artery (PCoA) those are located some distance away from the junction of the internal carotid artery (ICA) have been reported to be “true” PCoA aneurysms. They are extremely rare with incidence ranges from 0.1% to 2.8% of all aneurysms. We encountered 2 cases of true PCoA aneurysms those are treated by endovascular surgery.

Case 1: A 64-year-old woman presented with sudden onset of headache. Computed tomography (CT) scan showed diffuse thick subarachnoid hemorrhage. She was classified as WFNS grade II. Digital subtraction angiography (DSA) showed a right PCoA aneurysm. And coil embolization was performed on Day 1. During the procedure, balloon assist technique was introduced because of broad neck. No evidence of fresh ischemic lesion was detected on the post embolization CT scan. The patient presented no neurological symptoms after ventriculo-peritoneal shunt for communicating hydrocephalus. No recanalization was observed on the follow-up angiography taken on 2 months later.

Case 2: A 79-year-old-man presented with right blephaloptosis. Suspecting a right ICA – PCoA aneurysm on magnetic resonance image, he was referred to us for treatment. DSA showed a right true PCoA aneurysm. The aneurysm was dumb-bell shape and projected inferolaterally. Coil embolization was performed 3 days later. Post embolization course was uneventful and the right oculomotor palsy resolved gradually. Neither case showed remaining neurological symptoms or rerupture. These experiences suggest that endovascular surgery is feasible for these lesions from the standpoint of less invasive surgery. But special consideration must be paid to the perforating arteries from the PCoA.