J Korean Neurosurg Soc.  2010 Oct;48(4):354-356.

Recanalization of Completely Thrombosed Non-Giant Saccular Aneurysm Mimicking as De Novo Aneurysm

• Choi YS
• Kim DW
• Jang SJ
• Kang SD

Abstract

Partial thrombosis of giant aneurysms is not uncommon however, complete angiographic occlusion occurs less frequently. In the case of non-giant aneurysms, complete thrombosis and recanalization has been rarely reported. A 31-year-old man presented to the emergency department with sudden bursting headache. Brain computed tomography (CT) revealed diffuse subarachnoid hemorrhage on the left side. Both CT angiography (CTA) and digital subtraction angiography showed suspicion of small left anterior choroidal artery aneurysm. We performed surgical exploration. In the operation field, anterior choroidal artery aneurysm of 2 x 2 mm with broad neck and friable appearance was observed. Because we could not clip without sacrificing the anterior choroidal artery, we performed wrapping only. Follow up CTA after 7 months demonstrated 4 mm right internal carotid artery bifurcation aneurysm. The patient underwent aneurismal neck clipping. During the operation, 9 x 13 mm sized thrombosed aneurysm was detected and completely clipped. We initially thought this aneurysm to be a de novo aneurysm however, it was an aneurysm that had recanalized from a completely thrombosed aneurysm. This case report provides an insight into the potential for complete thrombosis and recanalization of non-giant aneurysms.

Keyword

Cerebral aneurysm; Thrombosis; Recanalization

MeSH Terms

Adult
Aneurysm
Angiography
Angiography, Digital Subtraction
Arteries
Brain
Carotid Artery, Internal
Choroid
Emergencies
Follow-Up Studies
Headache
Humans
Intracranial Aneurysm
Neck
Subarachnoid Hemorrhage
Thrombosis