Abstract Details

Title Coexistence of Multiple Non-Inflammatory Intracranial, Extracranial, Pancreaticoduodenal and Anterior Spinal Artery Aneurysms

Topic Interventional Neurology

Presentation(s) P04 - (-)

Poster/Presentation
Number 093

Objective

Background BACKGROUND: Multiple intracranial aneurysms may be associated with a variety of systemic diseases including polyarteritis nodosa, sickle cell anemia, mycotic aneurysms secondary to bacterial endocarditis and drug-induced vasculopathy.

Design/Methods DESIGN/METHODS: Case report.

Results RESULTS: A 47 year old female with sickle cell trait presented seven years ago with acute left midbrain infarct and three millimeter basilar artery aneurysm and chronic pontine infarct. She underwent endovascular occlusion and coiling of the basilar aneurysm. MRA eight months later revealed bilateral intracranial aneurysms of the middle, posterior, anterior cerebral and ophthalmic arteries, extracranial aneurysms and mild tortuosity of the right renal artery. Over several years, serial imaging revealed evolution of known aneurysms and formation of multiple new aneurysms. Enlargement of aneurysms led to resection and histopathologic analysis showing no evidence of fibromuscular dysplasia or polyarteritis. Tests were also negative for polyarterities nodosa, sickle cell anemia, bacterial endocarditis and drug-induced vasculopathy. Recently, patient experienced cerebral hemorrhage with left hemiparesis. Conventional angiography demonstrated the older aneurysms and an increase in intracranial and extracranial aneurysms, and new findings of anterior spinal, pancreaticodudenal, intrarenal, transverse pancreatic, colic arteries and multiple peripheral microaneurysms involving jejunal branches of the SMA. Biopsy of the superficial temporal artery aneurysm showed no evidence of inflammation or necrosis or polyarteritis nodosa. Extensive rheumatological workup was again negative.

Conclusions CONCLUSIONS: Coexistence of intracranial, extracranial and intraabdominal artery aneurysms has been very rarely reported in the literature. Pancreaticoduodenal aneurysms (PDA) make up only 2% of all visceral artery aneurysms according to the literature. To the best of our knowledge the coexistence of PDA and intracranial aneurysms has never been reported in the past. The etiology of the aneurysms seems to be non-inflammatory in nature.

Authors/Disclosures
Artin Minaeian, MD (Artin Minaeian MD Inc) PRESENTER	No disclosure on file
Aaron Ellenbogen, DO	Dr. Ellenbogen has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for allergan. Dr. Ellenbogen has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for allergan. Dr. Ellenbogen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Ellenbogen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Supernus. Dr. Ellenbogen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for ipsen. Dr. Ellenbogen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Acorda.
Neetu Dhadwal, MD (Sebastian River Medical Center)	No disclosure on file
Mihaela F. Hangan, MD (POCONO ADVANCED MEDICAL CLINIC, PC)	No disclosure on file
Brij M. Singh Ahluwalia	No disclosure on file

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