A case of amnesic syndrome after coil embolization for ruptured internal carotid-anterior choroidal artery aneurysm with hypoplastic posterior communicating artery

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  • UEMIYA Nahoko
    Department of Endovascular Neurosurgery, Saitama Medical University International Medical Center
  • ISHIHARA Shoichiro
    Department of Endovascular Neurosurgery, Saitama Medical University International Medical Center
  • MAESHIMA Shin-ichiro
    Department of Rehabilitation Medicine, Saitama Medical University International Medical Center
  • OHSAWA Aiko
    Department of Rehabilitation Medicine, Saitama Medical University International Medical Center
  • NEKI Hiroaki
    Department of Endovascular Neurosurgery, Saitama Medical University International Medical Center
  • OCHIAI Ikuo
    Department of Endovascular Neurosurgery, Saitama Medical University International Medical Center
  • SHIMAGUCHI Hidetoshi
    Department of Endovascular Neurosurgery, Saitama Medical University International Medical Center
  • KANAZAWA Ryuzaburo
    Department of Endovascular Neurosurgery, Saitama Medical University International Medical Center
  • YAMANE Fumitaka
    Department of Endovascular Neurosurgery, Saitama Medical University International Medical Center

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Other Title
  • 低形成の後交通動脈を有する破裂内頚動脈-前脈絡叢動脈破裂脳動脈瘤の塞栓術後に健忘症候群を呈した1例
  • 症例報告 低形成の後交通動脈を有する破裂内頚動脈-前脈絡叢動脈破裂脳動脈瘤の塞栓術後に健忘症候群を呈した1例
  • ショウレイ ホウコク テイケイセイ ノ アト コウツウ ドウミャク オ ユウスル ハレツ ナイ ケイドウミャク-ゼン ミャクラクソウドウミャク ハレツ ノウ ドウミャクリュウ ノ ソクセン ジュツゴ ニ ケンボウ ショウコウグン オ テイシタ 1レイ

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Abstract

Objective: We report a case of severe memory impairment after coil embolization for multiple cerebral aneurysms including a ruptured internal carotid (IC)-anterior choroidal artery aneurysm with hypoplastic posterior communicating artery.<br>Case presentation: A 34-year-old right-handed man suffered a sudden headache and was admitted to our hospital. Subarachnoid hemorrhage due to a ruptured aneurysm was diagnosed. Coil embolization of three cerebral aneurysms including an IC-anterior choroidal artery aneurysm was performed. After surgery, he had neither motor paresis nor sensory disturbance, but showed disorientation and both retrograde and anterograde amnesia. Although immediate recall and remote memory were almost intact, his recent memory was moderately impaired and his verbal and non-verbal memories were completely impaired. Brain magnetic resonance imaging revealed cerebral infarcts in the genu of the right internal capsule and splenium of the corpus callosum, and so on. We believe that memory impairment was because of damage to the Papez circuit with temporary interruption of the anterior choroidal artery.<br>Conclusion: Coil embolization for IC-anterior choroidal artery aneurysm may cause memory impairment because the thalamotuberal artery arises from the anterior choroidal artery in this case, and because temporary interruption of this artery damaged the Papez circuit directly. Therefore, we should pay attention to temporary interruption of the posterior communicating artery and anterior choroidal artery caused by coils or thromboembolic events.

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