Mirror aneurysm of ICA terminus associated with adult polycystic kidney disease
DOI:
https://doi.org/10.15584/ejcem.2021.4.12Keywords:
autosomal dominant polycystic kidney disease, ICA terminus aneurysm, mirror aneurysmAbstract
Introduction. Bilatereal saccular cerebral aneurysms (SCAs) that developed symmetrically on the same named vessels are defined as mirror aneurysms and account for a small subset of multiple cerebral aneurysms. The internal carotid artery (ICA) bifurcation is a rare location for mirror aneurysms.
Aim. We aimed to present the importance of risk status assessment for SCAs and screening in all ADPKD patients for timely detection and managementof SCAs before catastrophic complications occur.
Description of the case. We present mirror aneurysms of bilateral ICA bifurcation that appear like a couple of dancing men on coronal computed tomography angiography (CTA) images, which were successfully treated with single stage coil embolization in a 45 year old female patient with medical history of autosomal dominant policystic kidney disease (ADPKD).
Conclusion. SCAs are more frequent in patients with ADPKD than in general population and also these aneurysms are more likely to rupture at earlier ages. Mirror aneurysms of ICA terminus can be treated effectively and safely by single stage coil embolization.
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References
Takahashi S. Neurovascular Imaging, MRI & Microangiography. Springer Verlag. 2010; 2010:1848821336.
Meissner I, Torner J, Huston J, et al. Mirror aneurysms: a reflection on natural history. J Neurosurg. 2012;116(6):1238-1241.
Mackey J, Brown RD Jr, Moomaw CJ, et al. Unruptured intracranial aneurysms in the Familial Intracranial Aneurysm and International Study of Unruptured Intracranial Aneurysms cohorts: Differences in multiplicity and location. J Neurosurg. 2012;117:60-64.
Ong AC. Screening for intracranial aneurysms in ADPKD. BMJ. 2009;21(2):339.
Broderick JP, Brown RD Jr, Sauerbeck L, et al. Greater rupture risk for familial as compared to sporadic unruptured intracranial aneurysms. Stroke. 2009;40:1952-1957.
Grossman RI, Yousem DM, et al. Neuroradiology. St. Louis, MO: Mosby-Year Book. 2003:173-241.
Ho Choi H, Dae Cho Y, Yoo DH, et al. Intracranial Mirror Aneurysms: Anatomic Characteristics and Treatment Options. Korean J Radiol. 2018;19(5):849-858.
Masui K, Wajima D, Aketa S. Characteristics of the ruptured intracranial cerebral aneurysms in patients with autosomal dominant polycystic kidney disease (ADPKD) and review of literature. Interdisciplinary Neurosurgery. 2020;22:100846.
Flahault A, Trystram D, Nataf F, et al. Screening for intracranial aneurysms in autosomal dominant polycystic kidney disease is cost-effective. Kidney Int. 2018;93(3):716-726.
Thompson BG, Brown RD, Amin-Hanjani S, et al. Guidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015;46(8):2368-2400.
Lee V, Dexter M, Mai J, et al. KHA-CARI 2015 Autosomal Dominant Polycystic Kidney Disease Guideline: Management of Intracranial Aneurysms. Seminers in Nephrology. 2015;35(6):612-617.
Chapman AB, Devuyst O, Eckardt KU, et al. Autosomal-dominant polycystic kidney disease (ADPKD): executive summary from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2015;88(1):17-27.
Malhotra A, Wu X, Matouk CC, Forman HP, Gandhi D, Sanelli P. MR Angiography Screening and Surveillance for Intracranial Aneurysms in Autosomal Dominant Polycystic Kidney Disease: A Cost-effectiveness Analysis. Radiology. 2019;291:400-408.
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