Neurological Surgery No Shinkei Geka Volume 41, Issue 3 (March 2013)

Blood Blister-like Aneurysm on the Posterior Wall of the Internal Carotid Artery Causing Subarachnoid Hemorrhage: A Case Report Motofumi KOGUCHI 1 , Kenji SUZUYAMA 1 , Taku UCHIYAMA 1 , Hiroaki OKAMOTO 1 , Yukinori TAKASE 2 , Masatou KAWASHIMA 2 , Toshio MATSUSHIMA 2 1Department of Neurosurgery, Karatsu Red Cross Hospital 2Department of Neurosurgery, Faculty of Medicine, Saga University Keyword: blood blister-like aneurysm , posterior wall , proximal occlusion pp.229-234
Published Date 2013/3/10
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 We report a case of blood blister-like aneurysm(BBA)on the posterior wall of the internal carotid artery(ICA)causing subarachnoid hemorrhage(SAH). A 45-year-old man suffering from SAH(WFNS grade 5)was referred to our hospital. 3D-CT angiography showed a BBA on the posterior wall of the ICA. The aneurysm had been enlarged for a few days. Therefore we performed coil embolization. Four weeks after the operation, the aneurysm was found to have regrown. In the second operation the aneurysm was successfully treated by the ICA proximal occlusion with extracranial-intracranial bypass. Postoperative follow-up cerebral angiography detected no aneurysm. To our knowledge, BBA on the posterior wall of the ICA is rare. Radical surgery with bypass should be performed as soon as possible when the BBA is found to regrow. We discuss the clinical characteristics with a review of the literature.

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Neurological Surgery 脳神経外科
41巻3号 (2013年3月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院