scholarly journals Incomplete Oculomotor Nerve Palsy Caused by an Unruptured Internal Carotid-Anterior Choroidal Artery Aneurysm

2005 ◽  
Vol 45 (3) ◽  
pp. 143-147 ◽  
Author(s):  
Yasutaka KUROKAWA ◽  
Eri ISHIZAKI ◽  
Ken-ichi INABA
Keyword(s):  
Nerve Palsy ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Anterior Choroidal Artery ◽  
Anterior Choroidal ◽  
Choroidal Artery

Endovascular coil embolization of anterior choroidal artery aneurysms

2009 ◽  
Vol 111 (5) ◽  
pp. 963-969 ◽  
Author(s):  
Hyun-Seung Kang ◽  
Bae Ju Kwon ◽  
O-Ki Kwon ◽  
Cheolkyu Jung ◽  
Jeong Eun Kim ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Thromboembolic Events ◽  
Anterior Choroidal Artery ◽  
Endovascular Coil Embolization ◽  
Anterior Choroidal ◽  
Choroidal Artery

Object Anterior choroidal artery (AChA) aneurysms are difficult to treat, and the clinical outcome of patients is occasionally compromised by ischemic complications after clipping operations. The purpose of this study was to document the outcome and follow-up results of endovascular coil embolization in patients with AChA aneurysms. Methods Between July 1999 and March 2008, 88 patients with 90 AChA aneurysms (31 ruptured and 59 unruptured aneurysms) were treated with endovascular coil embolization in 91 sessions. There were 87 small aneurysms (< 10 mm) and 3 large aneurysms, with a mean aneurysm volume of 60.9 ± 83.3 mm3. Preprocedural oculomotor nerve palsy associated with AChA aneurysms was noted in 8 patients. Efficacy and safety were evaluated based on the degree of initial occlusion, procedure-related complications, patient outcome based on the Glasgow Outcome Scale score, and follow-up results. Results The degree of angiographic occlusion of the aneurysms was complete for 15 aneurysms (17%), near complete for 69 aneurysms (77%) and partial for 6 aneurysms (7%). There were 4 (4.4%) symptomatic procedure-related complications (3 thromboembolic events and 1 procedural hemorrhage). The procedural hemorrhage resulted in death; however, the thromboembolic events only caused transient deficits. A favorable outcome (Glasgow Outcome Scale score of 5 or 4) was achieved in 90% (79 of 88) of the patients at the time of discharge. No patient showed signs of bleeding or rebleeding during the follow-up period (mean 25 months). Major aneurysm recanalization occurred in 2 cases. The AChA aneurysm–associated oculomotor nerve palsy tended to become aggravated transiently after coil embolization and then completely recovered over the course of 2–9 months. Conclusions Coil embolization is a safe and effective treatment modality in cases of AChA aneurysms. Coil embolization enables procedural recognition of arterial compromise and immediate reestablishment of flow, thus contributing to a favorable outcome.

scholarly journals Delayed brain infarction caused by mechanical compression of the anterior choroidal artery after coil embolization for a large internal carotid-posterior communicating artery aneurysm: A case report

2020 ◽  
Vol 8 ◽  
pp. 2050313X2093375
Author(s):  
Naoki Wakuta ◽  
Satoshi Yamamoto
Keyword(s):  
Coil Embolization ◽  
Internal Carotid ◽  
Brain Infarction ◽  
Artery Aneurysm ◽  
Posterior Communicating Artery ◽  
Anterior Choroidal Artery ◽  
Mechanical Compression ◽  
Posterior Communicating Artery Aneurysm ◽  
Anterior Choroidal ◽  
Choroidal Artery

A 65-year-old male received coil embolization for a large internal carotid-posterior communicating artery aneurysm. Pre- and postoperative angiography at surgery demonstrated that the ipsilateral anterior choroidal artery branched from the internal carotid artery near the distal side of the aneurysm, and elevated and expanded on the aneurysmal dome, but was clearly visualized. Three days following endovascular treatment, the patient presented hemiparesis on the left side, with brain infarction in the territory of the right anterior choroidal artery despite antithrombotic therapy. The delayed brain infarction was likely caused by a reduction in anterior choroidal artery perfusion caused by mechanical compression following a postoperative increase in internal carotid-posterior communicating artery aneurysmal volume during intra-aneurysmal thrombosis. Transient volume expansion after coil embolization for intracranial aneurysms is rarely reported as a cause of brain infarction. It is important to recognize these arteries as potential postoperative complication risks, and consider the use of open surgery to avoid this risk.

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