A Rare Complex Case Report: Bilateral Congenital Internal Carotid Artery Hypoplasia Associated with Ruptured Left True Posterior Communicating Artery Aneurysm.

Asian journal of neurosurgery Pub Date : 2024-06-24 eCollection Date: 2024-09-01 DOI:10.1055/s-0044-1787861
Tushar V Soni, Shreyansh Patel, Varshesh Shah, Manas Ranjan Deo, Kuldeep Kotadiya
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Abstract

Congenital internal carotid artery hypoplasia is a rare condition characterized by underdevelopment or reduced caliber of the internal carotid artery during embryonic development. This anomaly presents significant challenges in management, particularly in neurosurgical interventions for cerebrovascular events. We present a case report of a 67-year-old male who presented with subarachnoid hemorrhage and intraparenchymal hemorrhage extending as intraventricular hemorrhage due to a ruptured left true posterior communicating artery aneurysm, associated with intraoperative findings of left internal carotid artery aneurysm, accompanied by incidental findings of bilateral congenital hypoplasia of the internal carotid artery on computed tomography angiography. Surgical intervention involved a left frontotemporal craniotomy, during which both aneurysms were successfully clipped. This case underscores the critical importance of meticulous preoperative evaluation, utilizing advanced neuroimaging modalities to identify such anomalies, particularly in patients with acute cerebrovascular events. Furthermore, it emphasizes the necessity for meticulous surgical planning and intraoperative vigilance to effectively manage associated vascular pathologies.

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罕见的复杂病例报告:双侧先天性颈内动脉发育不良伴左侧真后交通动脉瘤破裂。
先天性颈内动脉发育不全是一种罕见的疾病,其特点是颈内动脉在胚胎发育过程中发育不全或口径变小。这种异常给治疗带来了巨大挑战,尤其是在神经外科介入治疗脑血管事件方面。我们报告了一例 67 岁男性患者的病例,该患者因左侧真后交通动脉瘤破裂导致蛛网膜下腔出血和实质内出血,并伴有术中发现的左侧颈内动脉瘤,同时在计算机断层扫描血管造影中偶然发现双侧颈内动脉先天发育不良。手术治疗包括左侧额颞部开颅手术,手术中成功剪除了两个动脉瘤。本病例强调了术前细致评估的重要性,利用先进的神经影像学模式来识别此类异常,尤其是在急性脑血管事件患者中。此外,该病例还强调了细致的手术规划和术中警惕的必要性,以有效处理相关的血管病变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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