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A Case of Ruptured True Posterior Communicating Artery Aneurysm Thirteen Years after Surgical Occlusion of the Ipsilateral Cervical Internal Carotid Artery Kuniaki OGASAWARA 1,2 , Yoshihiro NUMAGAMI 1 , Masakazu KITAHARA 1 1Department of Neurosurgery, Ishinomaki Red Cross Hospital Keyword: True posterior communicating artery aneurysm , Internal carotid artery occlusion , Hemodynamic stress , Contralateral zygomatic approach pp.359-363
Published Date 1995/4/10
DOI https://doi.org/10.11477/mf.1436901012
  • Abstract
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A case is presented of ruptured“true”posterior com-municating artery aneurysm thirteen years after surgic-al occlusion of the ipsilateral cervical internal carotid artery.

A 58-year-old female developed the sudden onset of blepharoptosis on the right side. She had had a right superficial temporal artery-middle cerebral artery anas-tomosis and a surgical occlusion of the right cervical in-ternal carotid artery 13 years earlier for a subarachnoid hemorrhage that occurred as the result of a ruptured aneurysm of the right internal carotid artery. Neurolo-gical examination on admission revealed an occulomo-tor palsy on the right. Cerebral angiograms demons-trated an, aneurysm arising from the right posterior communicating artery itself near the right posterior cerebral artery. Also, the right intracranial internal carotid artery was supplied through the right posterior communicating artery. Five days later she experienced the sudden onset of severe headache. CT scan showed subarachnoid hemorrhage in the ambient cistern. Neck clipping of the aneurysm was successfully performed by the contralateral zygomatic approach. The pos-toperative course was uneventful.

It has been well known that internal carotid artery occlusion may be associated with cerebral aneurysm in some cases. However, it seems to be very rare that a “true”posterior communicating artery aneurysm should occur following the ipsilateral carotid artery occlusion. Hemodynamic factors were strongly suggested as the reason for aneurysmal formation in this case.


Copyright © 1995, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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