Giant Intracranial Aneurysm  

Oleh:

Kumar, Vishesh ; Ogilvy, Christopher S.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 364 no. 10 (Mar. 2011), page 956.
Topik: Endovascular Repair
Fulltext: Intracranial Aneurysm.pdf (57.18KB)

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2011.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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A 56-year-old woman with hypertension underwent an evaluation for recurrent syncope. On physical examination, the blood pressure and heart rate were normal, with no observed bradycardia or pauses on telemetry, and the respiratory rate and oxygen saturation were normal. The funduscopic examination was normal, with no signs of papilledema. Computed tomographic (CT) angiography of the head showed a partially thrombosed giant paraclinoid aneurysm of the left internal carotid artery, measuring 5 cm in diameter (Panels A and B, arrows). Six years earlier, an aneurysm of the left internal carotid artery (2.2 cm by 1.3 cm) had been diagnosed, but the patient was subsequently lost to follow-up. During the year before the current presentation, increasing forgetfulness, subjective gait instability, headaches, and urinary incontinence had developed. Despite the patient's reports of occasional dizziness, motor, sensory, cerebellar, gait, and cranial-nerve examinations were normal. The aneurysm was compressing the third and lateral ventricles, resulting in hydrocephalus and ventricular dilatation (Panel C, arrow). The patient underwent placement of a ventriculopleural shunt, with marked improvement in headaches, cognition, and subjective gait stability. On repeat CT, there was complete resolution of the hydrocephalus and decreased ventricular size. The patient is being followed at the aneurysm clinic, where she is being evaluated for endovascular repair of the intracranial aneurysm.

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