CC BY-NC-ND 4.0 · Asian J Neurosurg 2015; 10(04): 327-330
DOI: 10.4103/1793-5482.162721
CASE REPORT

The unusual angiographic course of intracranial pseudoaneurysms

Mario Zanaty
Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia
,
Nohra Chalouhi
Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia
,
Pascal Jabbour
Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia
,
Robert Starke
1   Department of Neurosurgery, University of Virginia, School of Medicine, Charlottesville, Virginia
,
David Hasan
2   Department of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, Iowa
› Author Affiliations

Although rare, traumatic intracranial pseudoaneurysms remain one of the most difficult vascular lesions to diagnose and treat. A 55-year-old male patient underwent endoscopic endonasal transphenoidal resection for a pituitary macroadenoma. The operation was complicated by an arterial bleed. The initial angiogram revealed pseudoaneurysm of the anterior choroidal artery. Although the pseudoaneurysm completely disappeared on the second angiogram, it was surprisingly found to have enlarged on the third angiogram. The lesion was successfully treated with flow-diversion using a pipeline embolization device. The present case demonstrates that the natural history of iatrogenic pseudoaneurysms may be unpredictable and misleading. Traumatic pseudoaneurysms should, therefore, be carefully followed when conservative treatment is elected or when the lesion seems to have spontaneously regressed. Flow-diversion seems to be a reasonable treatment option.



Publication History

Article published online:
22 September 2022

© 2015. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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