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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2019; 77(01): 63
DOI: 10.1590/0004-282X20190007
Images in Neurology

Heart-shaped intracranial aneurysm

Aneurisma intracraniano em forma de coração
Zheng Feng
1   China-Japan Union Hospital of Jilin University, Department of Pediatrics, Changchun, China;
,
Guibo Lin
2   China-Japan Union Hospital of Jilin University, Department of Rehabilitation, Changchun, China;
,
Ke Meng
3   China-Japan Union Hospital of Jilin University, Department of Neurosurgery, Changchun, China
,
Weidong Yu
3   China-Japan Union Hospital of Jilin University, Department of Neurosurgery, Changchun, China
,
Chao Fu 
3   China-Japan Union Hospital of Jilin University, Department of Neurosurgery, Changchun, China
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A 45-year-old woman presented with severe headache for three hours. Non-contrast brain CT revealed subarachnoid hemorrhage, mostly in the prepontine cistern ( [Figure] A). A catheter-based angiogram showed a heart-shaped aneurysm arising from the junction of the basilar artery and the left superior cerebellar artery ( [Figures] B and C), which was then coiled uneventfully ( [Figure] D).

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Figure (A) Non-contrast head CT shows subarachnoid hemorrhage in the prepontine cistern. (B-C) Catheter-based angiogram shows a heart-shaped saccular aneurysm (arrows) originating from the bifurcation of the basilar artery and the left superior cerebellar artery. (D) Postoperative angiogram shows the aneurysm (arrow) coiled successfully.

Cerebral aneurysm with a heart-shaped configuration is interesting and extremely rare, which is usually associated with vessel-wall degeneration under hemodynamic stress [1] . Surgical clipping is challenging because of the complex anatomic environment and fragile aneurysmal wall; while an endovascular procedure, as a straightforward option, seems to be feasible and effective [2],[3] .



Publikationsverlauf

Eingereicht: 28. August 2018

Angenommen: 01. Oktober 2018

Artikel online veröffentlicht:
21. August 2023

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  • References

  • 1 Vajkoczy P, Hartmann M. An unusual saccular aneurysm. N Engl J Med. 2002 Feb;346(7):497. https://doi.org/10.1056/NEJMicm010008
  • 2 Fu C, Zhao C, Zhao H, Li D, Yu W. Growing dissecting aneurysm of basilar trunk treated with stent-assisted coiling. J Stroke Cerebrovasc Dis. 2015 Jan;24(1):e5-9. https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.07.033
  • 3 Gong D, Yan B, Dowling R, Mitchell P. Successful treatment of growing basilar artery dissecting aneurysm by Pipeline flow diversion embolization device. J Stroke Cerebrovasc Dis. 2014 Jul;23(6):1713-6. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.11.019