Acta clinica Croatica, Vol. 59. No. 3., 2020.
Other
https://doi.org/10.20471/acc.2020.59.03.19
Late Aneurysm Relapse after Microsurgical Treatment of Middle Cerebral Artery Aneurysm: a Case Report and Literature Review of Treatment Options
Krešimir Rotim
; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; University of Applied Health Sciences, Zagreb, Croatia
Marina Raguž
; Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia
Ante Rotim
; Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia
Bruno Splavski
orcid.org/0000-0002-4483-9364
; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; University of Applied Health Sciences, Zagreb, Croatia; Josip Juraj Strossmayer University of Osijek, School of Dental Medicine and Health, Osijek, Croatia
Vladimir Kalousek
; Department of Radiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Abstract
Recurrence of intracranial aneurysm after initial microsurgical or endovascular treatment is uncommon. Although the exact etiology remains unknown, recurrent aneurysms may be observed in surgical patients with big and multiple aneurysms, arterial hypertension, non-atherosclerotic cerebrovascular arteriopathies, as well as in those with a familial history of the disease. Such recurrence can occur over a wide period ranging from several months to years after the initial aneurysm
treatment. Still, the occurrence delayed by more than 20 years is rather unusual. Herein, we present a case of a 70-year-old female patient who developed late intracranial aneurysm relapse 30 years after successful microsurgical clipping of the middle cerebral artery aneurysm. We also provide a brief review of relevant literature, discussing the etiology and pathophysiology of aneurysm reappearance, as well as different treatment options available. In conclusion, one should always consider the possibility of intracranial aneurysm recurrence regardless of the mode and time of primary surgery. In such a case, a multidisciplinary management approach using flow diverting endovascular techniques is advised in selected patients.
Keywords
Aneurysm, intracranial; Late recurrence; Treatment options, microsurgical and endovascular
Hrčak ID:
247642
URI
Publication date:
1.9.2020.
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