J Cerebrovasc Endovasc Neurosurg.  2016 Dec;18(4):402-406. 10.7461/jcen.2016.18.4.402.

Spontaneous Regression of Aneurysm Remnant after Incomplete Surgical Clipping in a Patient with Ruptured Cerebral Aneurysm

• Jun HS
• Ahn J
• Song JH
• Chang IB

• KMID: 2367334
• DOI: http://doi.org/10.7461/jcen.2016.18.4.402

Abstract

Cases of spontaneous regression of cerebral aneurysm remnant after incomplete surgical clipping have been rarely reported. This paper reports the regression of an aneurysm remnant after incomplete surgical clipping during postsurgical follow-up. A 50-year-old male presented with subarachnoid hemorrhage because of rupture of an anterior communicating artery aneurysm. An emergency clipping of the aneurysm was performed. A cerebral angiography, which was performed two weeks postoperatively, revealed an aneurysm remnant. The patient refused additional treatment and was discharged without apparent neurological deficit. One-year follow up cerebral angiography demonstrated a partially regressed aneurysm remnant.

Keyword

Ruptured intracranial aneurysm; Neck clipping; Aneurysm remnant; Spontaneous regression

MeSH Terms

Aneurysm*
Cerebral Angiography
Emergencies
Follow-Up Studies
Humans
Intracranial Aneurysm*
Male
Middle Aged
Rupture
Subarachnoid Hemorrhage
Surgical Instruments*

Figure

• 

  Fig. 1 Brain computed tomography demonstrated subarachnoid hemorrhage in the basal cistern and a hematoma on the left frontal lobe. (A) Subsequent digital subtraction angiography revealed a ruptured anterior communicating artery aneurysm. (B) Left anteroposterior view. (C) 3D reconstruction.

• 

  Fig. 2 Digital subtraction angiography obtained two weeks after surgery showed remnant aneurysm behind the clip (arrow). (A) Left anterior oblique view. (B) 3D reconstruction.

• 

  Fig. 3 One-year follow-up cerebral angiography demonstrated regression of the remnant aneurysm, leaving a small saccular aneurysm (arrow). (A) Left anterior oblique view. (B) 3D reconstruction.

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