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Posterior Communicating Artery Aneurysm: Multiple Aneurysms, Diagnosed in Mother and Daughter, the Increased Rupture Risk, Consequences for Diagnostic Protocols, and Treatment Decisions

  • Muhammad AlMatter
  • Marta Aguilar Pérez
  • Hans Henkes
Living reference work entry

Abstract

An incidental cerebral aneurysm of the left internal carotid artery (ICA) at the origin of the posterior communicating artery (PcomA) was diagnosed on a screening MRI, which was performed due to the diagnosis of multiple cerebral aneurysms in the patient’s mother. The diagnostic angiography revealed an additional small incidental left middle cerebral artery (MCA) aneurysm. The left PcomA aneurysm ruptured prior to the scheduled treatment, resulting in a subarachnoid hemorrhage (SAH). The clinical condition of the patient was graded at Hunt and Hess III, and the ruptured aneurysm was immediately treated by coiling with subtotal occlusion. The left MCA aneurysm was subsequently treated by microsurgical clipping. Due to progressive reperfusion of the ruptured PcomA aneurysm, the treatment was completed by putting a flow diverter (FD) in place, which led to the complete exclusion of the aneurysm remnant while preserving the flow into the covered PcomA. The issue of familial aneurysms is the main topic of this chapter.

Keywords

Familial aneurysm Subarachnoid hemorrhage Flow diverter Coil occlusion Microsurgical clipping 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Muhammad AlMatter
    • 1
  • Marta Aguilar Pérez
    • 1
  • Hans Henkes
    • 1
  1. 1.Neuroradiologische KlinikKlinikum StuttgartStuttgartGermany

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