True Posterior Communicating Artery Aneurysm Associated with Arteriovenous Malformation: First Report and Literature Review with Special Focus on Flow Alterations

Introduction

True posterior communicating artery (PCoA) aneurysms represent extremely rare lesions, the precise frequency of which remains unknown. These aneurysms are located on the trunk of the PCoA and should be differentiated from common aneurysms, which involve the origin of the PCoA from the internal carotid artery (ICA). However, diagnosis of these aneurysms is difficult when they are located close to the ICA. In some of the previously reported cases, the correct diagnosis was only achieved during surgery [15] [17] [19] [38] [40]. Three dimensional (3D) reconstructions of digital substraction angiography (DSA) and/or computed tomography angiography (CTA) are needed for optimal preoperative evaluation and surgical treatment of these lesions.

Although true PCoA aneurysms associated with increased blood flow through the PCoA have been reported previously [4] [10] [25], we present here–to the best of our knowledge – the first report of such an aneurysm associated with a brain arteriovenous malformation (AVM).

References

• 1 Abiko1  S, Orita1  T. A case of “true” posterior communicating artery aneurysm (author's transl).  No Shinkei Geka. 1981;  9 1181-1185
• 2 Akimura T, Abiko S, Ito H. True posterior communicating artery aneurysm.  Acta Neurol Scand. 1991;  84 207-209
• 3 Alpers BJ, Schlezinger NS. Aneurysm of the posterior communicating artery.  Arch Ophthal. 1949;  42 353-364
• 4 Freitas JM, Pieruccetti MA, Andrade GC. et al . High flow “true” posterior communicating artery aneurysm due to hemodynamic effect in a patient with subclavian artery occlusion treated with angioplasty.  Arq Neuropsiquiatr. 2005;  63 693-696
• 5 Hayashi T, Sakakibara Y, Yamashita K. et al . A case of true posterior communicating artery aneurysm.  Surgery for Cerebral Stroke. 1993;  21 493-496
• 6 Hernesniemi J, Ishii K, Niemela M. et al . Lateral supraorbital approach as an alternative to the classical pterional approach.  Acta Neurochir Suppl. 2005.  94 17-21
• 7 Imai K. True posterior communicating artery aneurysm: Case report.  Jpn J Neurosurg (Tokyo). 2001;  10 626-630
• 8 Ishikawa T, Kazumata K, Ni-iya Y. et al . Subarachnoid hemorrhage as a result of fungal aneurysm at the posterior communicating artery associated with occlusion of the internal carotid artery: case report.  Surg Neurol. 2002;  58 261-265
• 9 Kamiyama K, Sakurai Y, Suzuki J. Case report: aneurysm of the posterior communicating artery itself--report of a successfully treated case.  Neurol Med Chir (Tokyo). 1980;  20 81-84
• 10 Kaspera W, Majchrzak H, Kopera M. et al . “True” aneurysm of the posterior communicating artery as a possible effect of collateral circulation in a patient with occlusion of the internal carotid artery. A case study and literature review.  Minim Invasive Neurosurg. 2002;  45 240-244
• 11 Kawaguchi S, Noguchi H, Yonezawa T. et al . Giant true posterior communicating artery aneurysm.  J Stroke Cerebrovasc Dis. 1998;  7 259-262
• 12 Koga H, Tsuji T, Tabuchi K. Clipping of aneurysm arising from the posterior communicating artery itself by contralateral craniotomy: a case report.  No Shinkei Geka. 1994;  22 553-556
• 13 Krayenbuhl HA, Yasargil MG, Flamm ES. et al . Microsurgical treatment of intracranial saccular aneurysms.  J Neurosurg. 1972;  37 678-686
• 14 Kubo M, Kuwayama N, Hirashima Y. et al . Endovascular treatment of unusual multiple aneurysms of the internal carotid artery-posterior communicating artery complex – case report.  Neurol Med Chir (Tokyo). 2000;  40 476-479
• 15 Kudo T. An operative complication in a patient with a true posterior communicating artery aneurysm: case report and review of the literature.  Neurosurgery. 1990;  27 650-653
• 16 Madow L, Alpers BJ. Aneurysm of the posterior communicating artery; report of five additional cases.  AMA Arch Neurol Psychiatry. 1953;  70 722-732
• 17 Mandai S, Nishino S, Itoh T. et al . A case of fibromuscular dysplasia associated with intra and extracranial multiple aneurysms.  No Shinkei Geka. 1992;  20 611-615
• 18 Masuda T, Uno M, Matsumoto K. Relatively rare ruptured posterior communicating artery aneurysms: A case report.  Geka. 1984;  46 1081-1083
• 19 Matsumori Y, Kayama T, Kokubo Y. et al . A case of non-junctional posterior communicating artery aneurysm forming kissing aneurysms with an IC-PC aneurysm.  Surg Cereb Stroke (Jpn). 2003;  31 365-369
• 20 Matsumoto K,, Kuriyama M,, Tamiya T. et al . Direct clip obliteration of a ruptured giant aneurysm of the posterior communicating artery: case report.  Neurosurgery. 1997;  41 939-943
• 21 Meguro T, Terada K, Hirotune N. et al . A case of ruptured true posterior communicating artery aneurysm with neurogenic pulmonary edema treated early by GDC embolization.  No Shinkei Geka. 2005;  33 1001-1004
• 22 Miyazawa T, Watanabe H, Hasegawa T. et al . A case of posterior communicating artery aneurysm associated with vascular anomaly of circle of Willis.  No Shinkei Geka. 1983;  11 541-546
• 23 Muneda K, Yoshizu H, Terada H. True posterior communicating artery aneurysm.  No Shinkei Geka. 2001;  29 163-168
• 24 Nakatsuka H, Ohta S, Kuroda J. et al . Ruptured true posterior communicating artery fusiform aneurysm: case report.  No Shinkei Geka. 2007;  35 691-696
• 25 Ogasawara K, Numagami Y, Kitahara M. A case of ruptured true posterior communicating artery aneurysm thirteen years after surgical occlusion of the ipsilateral cervical internal carotid artery.  No Shinkei Geka. 1995;  23 359-363
• 26 Okada T, Matsuda M. A case of “true” posterior communicating artery aneurysm.  No Socchu. 1988;  10 270-274
• 27 Poppen JL. Specific treatment of intracranial aneurysms; experiences with 143 surgically treated patients.  J Neurosurg. 1951;  8 75-102
• 28 Pritz MB. Ruptured true posterior communicating artery aneurysm and cystic craniopharyngioma.  Acta Neurochir (Wien). 2002;  144 937-939
• 29 Redekop G, TerBrugge K, Montanera W. et al . Arterial aneurysms associated with cerebral arteriovenous malformations: classification, incidence, and risk of hemorrhage.  J Neurosurg. 1998;  89 539-546
• 30 Sano K. Introduction to the etiology of subarachnoid hemorrhage, with special reference to the management of ruptured cerebral aneurysms.  Nippon Rinsho. 1978;  36 460-466
• 31 Sorimachi T, Fujii Y, Nashimoto T. A true posterior communicating artery aneurysm: variations in the relationship between the posterior communicating artery and the oculomotor nerve. Case illustration.  J Neurosurg. 2004;  100 353
• 32 Stuntz JT, Ojemann GA, Alvord Jr EC. Radiographic and histologic demonstration of an aneurysm developing on the infundibulum of the posterior communicating artery. Case report.  J Neurosurg. 1970;  33 591-595
• 33 Takahashi A, Kamiyama H, Imamura H. et al . “True” posterior communicating artery aneurysm – report of two cases.  Neurol Med Chir (Tokyo). 1992;  32 338-341
• 34 Takeda N, Tamaki N, Asada M. et al . “True” posterior communicating artery aneurysm presenting the abducens nerve palsy.  No Shinkei Geka. 1985;  13 1331-1334
• 35 Tanizaki Y, Kobayashi S, Ichinose Y. et al . A case of “true” posterior communicating artery aneurysm with rare intraoperative misclipping.  Shinshu Igaku Zasshi. 1982;  30 396-401
• 36 Timothy J, Sharr M, Doshi B. Perils of a ‘true’ posterior communicating artery aneurysm.  Br J Neurosurg. 1995;  9 789-791
• 37 Trasi S, Vincent LM, Zingesser LH. Development of aneurysm from infundibulum of posterior communicating artery with documentation of prior hemorrhage.  AJNR Am J Neuroradiol. 1981;  2 368-370
• 38 Waga S, Kojima T, Tochio H. et al . Aneurysm of the posterior communicating artery itself.  Neurol Med Chir (Tokyo). 1984;  24 495-498
• 39 Yasargil MG. Carotid-posterior communicating aneurysms.. Microneurosurgery. Vol. II. Stuttgart: Georg Thieme Verlag; 1984: 71-98
• 40 Yoshida M, Watanabe M, Kuramoto S. “True” posterior communicating artery aneurysm.  Surg Neurol. 1979;  11 379-381

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