Multiple intracranial aneurysms with long-term follow-up: one case report

doi:10.3969/j.issn.1672-6731.2024.08.014

Abstract

Key words: Intracranial aneurysm, Embolization, therapeutic, Recurrence, Follow-up studies, Case reports

Shi-qiang WANG, Xiao-yan HE, Tao GENG, Chang-xing PENG. Multiple intracranial aneurysms with long-term follow-up: one case report[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(8): 689-694.

王时强, 何小燕, 耿涛, 彭昌兴. 颅内多发动脉瘤长期随访一例[J]. 中国现代神经疾病杂志, 2024, 24(8): 689-694.

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URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2024.08.014

https://journal11.magtechjournal.com/cjcnn/EN/Y2024/V24/I8/689

Figures/Tables 8

Figure 1 Before the first embolization, axial CT showed hematoma in the left fissure pool (arrow indicates).

Figure 2 DSA findings before and after the first embolization Anteroposterior DSA before embolization showed the 2 aneurysms in the M2 segment of left MCA were large in size and irregular in shape, which were considered as responsible aneurysms with relatively narrow neck (thin arrow indicates), while the aneurysm in the C5 segment of left ICA was small in size and regular in shape (thick arrow indicates, Panel 2a). Anteroposteric DSA immediately after embolization showed complete embolization of left MCA M2 aneurysms (arrow indicates, Panel 2b).

Figure 3 Follow-up imaging examination in April 2015 Preoperative lateral CTA showed left MCA M2 aneurysms no signs of recurrence, and left ICA C5 aneurysm with enlarged size, morphological changes and wide neck (arrows indicate, Panel 3a). Embolization of the left ICA C5 aneurysm with stent semi-release technique (arrow indicates, Panel 3b). Postoperative anteroposterior DSA immediately showed complete embolization of the left ICA C5 aneurysm (arrow indicates, Panel 3c). Postoperative anteroposterior DSA immediately showed smooth blood flow in the ACA and MCA (Panel 3d).

Figure 4 Follow-up CTA findings in December 2018 Frontal CTA showed the new right MCA M2 aneurysm and anterior communicating artery aneurysm (arrows indicate), and no signs of recurrence in embolized left MCA M2 aneurysms and left ICA C5 aneurysm (Panel 4a). Frontal CTA showed the right MCA M2 aneurysm and anterior communicating artery aneurysm (arrows indicate, Panel 4b).

Figure 5 Follow-up DSA findings in January 2019 Intraoperative anteroposterior DSA showed the right MCA M2 aneurysm (arrow indicates, Panel 5a). Intraoperative anteroposterior DSA showed anterior communicating artery aneurysm (arrow indicates, Panel 5b). Intraoperative anteroposterior DSA showed the right MCA M2 aneurysm was embolized with single catheter technique (arrow indicates, Panel 5c). Intraoperative anteroposterior DSA showed the anterior communicating artery aneurysm was embolized with double catheter technique (arrow indicates, Panel 5d). Postoperative anteroposterior DSA immediately showed complete embolization of the right MCA M2 aneurysm (arrow indicates, Panel 5e). Postoperative anteroposterior DSA immediately showed complete embolization of the anterior communicating artery aneurysm (arrow indicates, Panel 5f).

Figure 6 Follow-up in April 2019, frontal CTA showed no signs of recurrence in the left MCA M2, left ICA C5, right MCA M2, and anterior communicating artery aneurysms.

Figure 7 Follow-up imaging findings in April 2021 Frontal CTA before embolization showed increased volume of anterior communicating artery aneurysm, indicating signs of recurrence (arrow indicates, Panel 7a). Anteroposterior DSA before embolization showed no signs of recurrence in the right MCA M2 aneurysm (Panel 7b). Anteroposterior DSA before embolization showed signs of recurrence in the anterior communicating artery aneurysm (arrow indicates), and no signs of recurrence in the left MCA M2 aneurysms and left ICA C5 aneurysm (Panel 7c). Intraoperative anteroposterior DSA showed the anterior communicating artery aneurysm was embolized by single catheter technique (arrow indicates, Panel 7d). Postoperative anteroposterior DSA immediatehy showed the recurrent anterior communicating artery aneurysm was completely embolized (arrow indicates, Panel 7e).

Figure 8 Follow-up in March 2022 CTA showed no signs of recurrence in the left MCA M2, left ICA C5, right MCA M2, and anterior communicating artery aneurysms. Frontal CTA (Panel 8a). Oblique CTA (Panel 8b).

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