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Internal carotid artery-persistent primitive anterior choroidal artery aneurysms: report of two cases and literature review

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Abstract

Purpose

Persistent primitive anterior choroidal artery (PPAChA) is a rare vascular anomaly. The clinical course of internal carotid artery (ICA)-PPAChA aneurysms has not been well described.

Case reports

We report two patients with an ICA-PPChA aneurysm and summarize previously reported cases.

Results

Including our two, a total of 10 patients with an ICA-PPAChA aneurysm have been reported. Data were not described for one. Among the remaining nine, five patients (56%) experienced aneurysmal rupture. Five patients underwent surgical clipping and four underwent endovascular coiling. The procedure was completed in all but one patient who had a tiny branch artery adherent to the aneurysm; this patient was converted from clipping to aneurysm coating with a cotton sheet. Among the other eight patients, one who underwent coiling experienced an internal capsule infarction. The remaining seven had a satisfactory postoperative course; however, an asymptomatic occlusion of the PPAChA at its origin was noted on postoperative angiography in one.

Conclusion

PPChA is associated with a high incidence of aneurysm formation and rupture. During treatment of ICA-PPAChA aneurysms, obstruction of the PPAChA and any surrounding perforating arteries should be avoided to prevent ischemic stroke.

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Data availability

The original contributions presented in the study are included in the article/supplementary materials; further inquiries can be directed to the corresponding author/s.

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Acknowledgements

We thank Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Neurosurgery, Nakamura Memorial Hospital, South 1, West 14, Chuo-Ku, Sapporo, Hokkaido, 060-8570, Japan

    Yasuyuki Tatsuta, Hideki Endo, Tatsuya Ogino, Yohei Yamaguchi, Kenji Kamiyama, Toshiaki Osato & Hirohiko Nakamura

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  1. Yasuyuki Tatsuta
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  2. Hideki Endo
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  3. Tatsuya Ogino
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  4. Yohei Yamaguchi
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  5. Kenji Kamiyama
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  6. Toshiaki Osato
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  7. Hirohiko Nakamura
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Yasuyuki Tatsuta and Hideki Endo. The first draft of the manuscript was written by Yasuyuki Tatsuta and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yasuyuki Tatsuta.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the ethics committee of Nakamura Memorial Hospital (No. 2023030301).

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The authors declare no competing interests.

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Tatsuta, Y., Endo, H., Ogino, T. et al. Internal carotid artery-persistent primitive anterior choroidal artery aneurysms: report of two cases and literature review. Acta Neurochir 166, 94 (2024). https://doi.org/10.1007/s00701-024-05988-1

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