Coincidence of Anterior Communicating Artery Aneurysm in a Patient With Carotid Body Tumor: A Case Report
International Clinical Neuroscience Journal,
Vol. 4 No. 4 (2017),
8 October 2017
,
Page 157-159
Abstract
Background: Intracranial aneurysms (IAs) are focal pathologic dilation of cerebral vasculature, which mostly affect the anterior circulation of brain. Carotid body tumors (CBTs) are the most common head and neck parasympathetic paragangliomas. These slow growing neoplasms may cause hypertension along with catecholamine release symptoms, mostly in patients in their fourth decade. This is the second reported case of simultaneous presentation of CBT and IA in a male patient.
Case Presentation: A 54-year-old male with positive history of hypertension presented with isolated acute weakness of right upper extremity. Bilateral Doppler ultrasound of carotid arteries showed a mass at left carotid bifurcation, which was confirmed by vessels computed tomography (CT) – angiography. CT scan also demonstrated anterior communicating artery (A-Com) aneurysm. Digital subtraction angiography (DSA) confirmed a right sided A-com artery aneurysm. Aneurismal repair was performed prior to CBT removal.
Conclusion: Although multifactorial etiologies, such as hypertension, atherosclerosis and congenital predisposition with vascular abnormalities exists; this case raises the possibility of etiologic relationship between hypertension and hypertensive crises due to catecholamine release and aneurismal development and rupture. Avoidance of possible life threatening complications of aneurismal rupture necessitates preoperative evaluation for CBT in patients with established diagnosis of IA.
- Intracranial aneurysm
- Carotid body tumor
- Anterior communicating artery aneurysm
- Hypertension
- Screening
How to Cite
References
: Gasparotti R, Liserre R. Intracranial aneurysms. Eur Radiol 2005;15:441–7.
: Rinkel GJ, Djibuti M, Algra A, van Gijn J. Prevalence and risk of rupture of intracranial aneurysms: a systematic review. Stroke 1998;29:251–6.
: Bonneville F, Sourour N, Biondi A. Intracranial aneurysms: an overview. Neuroimaging Clin N Am 2006;16(3):371-82.
: Juvela S, Porras M, Poussa K. Natural history of unruptured aneurysms. J Neurosurg 2000;93:379–387.
: Juvela S. Prehemorrhage Risk Factors for Fatal Intracranial Aneurysm Rupture. Stroke 2003;34:1852-1858.
: de Franciscis S, Grande R, Butrico L, Buffone G, Gallelli L, Scarcello E, et al. Resection of carotid body tumors reduces arterial blood pressure. An underestimated neuroendocrine syndrome. Int J Surg 2014;12:S63–S67.
: Davidovic LB, Djukic VB, Vasic DM, Sindjelic RP, Duvnjak SN. Diagnosis and treatment of carotid body paraganglioma: 21 years of experience at a clinical center of Serbia. World J Surg Oncol 2005;3(1):10.
: Georgiadis GS, Lazarides MK, Tsalkidis A, Argyropoulou P, Giatromanolaki A. Carotid body tumor in a 13-year-old child: Case report and review of the literature. J Vasc Surg 2008;47(4):874-880.
: Milewski C. Morphology and clinical aspects of paragangliomas in the area of head-neck. HNO 1993;41:526–531.
: Inci S, Bertan V. Catecholamine-secreting carotid body tumor and intracranial aneurysm: coincidence? Surg Neurol 2000;53(5):488-92.
: Meyer FB, Sundt TM, Pearson BW. Carotid body tumors: a subject review and suggested surgical approach. J Neurosurg 1986;64:377–85.
: Eyzaguirre C, Zapata P. Perspectives in carotid body research. J App Physiol 1984;57:931–57.
: Sevilla Garcia MA, Llorente Pendas JL, Rodrigo Tapia JP, Garcia Rostan G, Suarez Fente V, Coca Pelaz A, et al. [Head and neck paragangliomas: revision of 89 cases in 73 patients]. Acta Otorrinolaringol Esp 2007;58(3):94-100.
: Anand VK, Alemar GD, Sanders TS. Management of the internal carotid artery during carotid body tumor surgery. Laryngoscope 1979;105:231–5.
: Weir B, Disney L, Karrison T. Sizes of ruptured and unruptured aneurysms in relation to their sites and the ages of patients. J Neurosurg 2002;96:64–70.
: Papke K, Kuhl CK, Fruth M, Haupt C, Schlunz-Hendann M, Sauner D, et al. Intracranial aneurysms: role of multidetector CT angiography in diagnosis and endovascular therapy planning. Radiology 2007;244(2):532-40.
: Frösen J, Tulamo R, Paetau A, Laaksamo E, Korja M, Laakso A, et al. Saccular intracranial aneurysm: pathology and mechanisms. Acta Neuropathol 2012 Jun;123(6):773-86.
: Gu YX, Chen XC, Song DL, Leng B, Zhao F. Risk factors for intracranial aneurysm in a Chinese ethnic population. Chin Med J (Engl) 2006;119(16):1359-64.
: de la Monte SM, Moore GW, Monk MA, Hutchins GM. Risk factors for the development and rupture of intracranial berry aneurysms. Am J Med 1985;78(6 Pt 1):957-64.
: Taylor CL, Yuan Z, Selman WR, Ratcheson RA, Rimm AA. Cerebral arterial aneurysm formation and rupture in 20,767 elderly patients: hypertension and other risk factors. J Neurosurg 1995;83(5):812-9.
: Andrew RJ, Spiegel PK. Intracranial aneurysms. Age, sex, blood pressure, and multiplicity in an unselected series of patients. J Neurosurg 1979;51:27–32.
: Fehlings MG, Gentili F. The association between polycystic kidney disease and cerebral aneurysms. Can J Neurol Sci 1991;18:505–9.
: Fukuda H, Sako K, Yonemasu Y. Coarctation of the descending aorta with aneurysm of the anterior communicating artery. Surg Neurol 1985;23:380 –2.
: Rodrigues JC, Hassan N, Williams M, Burchell AE, Ratcliffe LE, Hamilton M, et al. Should we screen for intracranial aneurysms (IAs) in systemic hypertension at the time of cardiac magnetic resonance (CMR)? J Cardiovasc Magn Reson 2015;17(Suppl 1):411.
- Abstract Viewed: 427 times
- PDF Downloaded: 252 times