Case Report : De Novo Posterior Thalamoperforating Artery Aneurysm Presenting with Subarachnoid Hemorrhage 7 Years after Surgery of a Posterior Cerebral Artery Aneurysm

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  • Ishikawa Tatsuya
    Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo, Japan
  • Ishiguro Taichi
    Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo, Japan
  • Yamaguchi Koji
    Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo, Japan
  • Kawashima Akitsugu
    Department of Neurosurgery, Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, Japan
  • Kawamata Takakazu
    Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo, Japan

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  • De Novo Posterior Thalamoperforating Artery Aneurysm Presenting with Subarachnoid Hemorrhage 7 Years after Surgery of a Posterior Cerebral Artery Aneurysm

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Objective: Posterior circulation perforating artery aneurysms are uncommon. Furthermore, a posterior thalamoperforating artery (pTPA) aneurysm arises from the P1 segment of the posterior cerebral artery (PCA) is rare. We report a case of de novo pTPA aneurysm treated by coil embolization.Case Presentations: A 51-year-old woman underwent clipping surgery for left P1 fusiform aneurysm 7 years before presentation. The left PCA (P1 segment) was unfortunately occluded, but the patient remained neurologically intact. A follow-up 3D-computed tomographic angiography (3D-CTA) 1 year after surgery showed no remnant aneurysm. 7 years after surgery, she experienced sudden stuporous condition and was transferred to our hospital (Hunt and Hess grade 4). A digital subtraction angiography (DSA) showed a small aneurysm arising from a perforator artery originating from the superior aspect of the left P1 and diagnosed as de novo pTPA aneurysm. Endovascular coil embolization from the orifice of the pTPA was performed.Conclusion: Aneurysms of the pTPA are rare. Hemodynamic stress due to the left PCA (P1 segment) occlusion might be a cause of this aneurysm. Endovascular treatment is a good option if catheterization is possible.

収録刊行物

  • 脳神経血管内治療

    脳神経血管内治療 10 (1), 36-39, 2016

    一般社団法人 日本脳神経血管内治療学会

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