Objective: The authors report the first case of intracranial fibromuscular dysplasia (FMD) presenting with rapid formation of an unruptured large vertebral artery (VA) fusiform aneurysm.
Case Presentation: A 41-year-old man presented with left hemiparesis. He had a giant thrombosed aneurysm at the basilar artery-superior cerebellar artery (BA-SCA) junction and a left extracranial VA aneurysm. A VA fusiform aneurysm developed during a 1-month interval following the first session of intravascular coil embolization for the BA-SCA aneurysm. Stress on the fragile artery due to FMD during micro-catheterization may have caused the aneurysm. An anomalous aortic origin of the left VA may also have played a role in the formation of the large aneurysm and extracranial VA aneurysm. We performed overlapping stent-assisted coil embolization for the VA fusiform aneurysm using an Enterprise VRDs, and coil embolization for the BA-SCA thrombosed aneurysm using the stent-assisted technique with an Enterprise stent. Both aneurysms remained occluded for 7 years.
Conclusion: We concluded micro-catheterization to be the cause of the large aneurysm. This case emphasizes the importance of carefully performing intravascular interventional procedures for patients with FMD.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10370797 | PMC |
| http://dx.doi.org/10.5797/jnet.cr.2019-0075 | DOI Listing |
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