AI Article Synopsis
- Infundibula, while often seen as minor anatomical variations, can sometimes be significant in causing serious health issues like subarachnoid hemorrhage (SAH).
- A 51-year-old man experienced a sudden severe headache, and imaging showed SAH associated with a left PCo-A infundibulum (IF).
- Surgical intervention revealed the IF as the cause of the SAH, emphasizing the importance of thorough investigation since such anatomical features can be mistaken as inconsequential.
Article Abstract
Background: Infundibula are frequently regarded as incidental anatomical variants that are of no pathogenetic significance.
Case Description: A 51-year-old man presented with a sudden onset of severe occipital headache. Computed tomographic scan revealed a predominantly perimesencephalic pattern of SAH with a slight bias toward the left side. Angiography demonstrated a left PCo-A IF as the sole abnormality. At craniotomy, the left PCo-A IF was found to represent the sole abnormality. The IF was markedly reddened posteriorly, contained a capping clot, and lay immediately adjacent to a mass of xanthochromatous tissue. The PCo-A was hypoplastic and lacked perforating vessels; therefore, the IF base was successfully clipped with a straight Sugita clip parallel to the left ICA. At discharge and at clinical follow-up, our patient was asymptomatic and lacked neurologic signs.
Conclusions: Infundibula may rarely represent a direct source of rupture and SAH. Exploratory craniotomy is required to establish the diagnosis and to provide definitive treatment. To label a case of SAH as angiogram-negative may be unwise when an IF potentially colocalizes to the SAH source.
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| http://dx.doi.org/10.1016/j.surneu.2006.05.066 | DOI Listing |
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