Discrepancy between Angiography and Operative Findings of Small Side Wall Aneurysms in Atherosclerotic Parent Arteries

Journal of Cerebrovascular and Endovascular Neurosurgery
Sook Young Sim

Abstract

Preoperative evaluation of precise aneurysmal geometry is important for the treatment of intracranial aneurysms. We present two cases of unclippable side wall aneurysms due to their extremely low dome height, which appeared as saccular in the preoperative image because of a comparatively narrow atherosclerotic parent arterial lumen. In both cases, a calcified vessel wall was noted preoperatively. Lack of a definitive neck and abrupt discrepancy between the fragile aneurysmal wall and the atherosclerotic parent arterial wall was confirmed intraoperatively in both cases. This study describes an illustrative mechanism for the finding with emphasis on the importance of its preoperative diagnosis. Intracranial atherosclerosis associated with small side walled aneurysms may lead to overestimation of aneurysm height on preoperative imaging of the intravascular compartment.

References

Jun 25, 2010·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Johanna T FifiE Sander Connolly
Mar 11, 2011·Annals of Neurology·Jan MenkeKai Kallenberg
Oct 24, 2014·Journal of Cerebrovascular and Endovascular Neurosurgery·Chang Kyu ParkJun Seok Koh
Sep 10, 2015·Stroke; a Journal of Cerebral Circulation·Matthew J GounisAlexei A Bogdanov
Oct 7, 2015·Journal of Stroke·Young Jun ChoiDeok Hee Lee

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