J Cerebrovasc Endovasc Neurosurg.  2015 Sep;17(3):252-256. 10.7461/jcen.2015.17.3.252.

Stent-assisted Coil Embolization of Petrous ICA in a Teenager with Neurofibromatosis

• Lee SH
• Jang JH
• Kim KH
• Kim YZ

• KMID: 2069252
• DOI: http://doi.org/10.7461/jcen.2015.17.3.252

Abstract

We herein report on a patient with a cerebral aneurysm located at the petrous portion of the internal carotid artery (ICA). An 18-year-old male, previously diagnosed with neurofibromatosis, was referred to our emergency service complaining of severe headache, pulsatile tinnitus, nausea, and vomiting which occurred suddenly. Neuro-radiological studies including computed tomography and magnetic resonance imaging of the cerebral artery showed a large aneurysm arising from the petrous segment of the left ICA. He was treated with a neuro-interventional technique such as intra-arterial stenting and coil embolization for the aneurysm. Several days after the interventional treatment, his symptoms were resolved gradually except for a mild headache. Symptomatic unruptured aneurysm at the petrous portion of the ICA is rare, and our patient was treated successfully using a neuro-intervention technique. Therefore, we describe a case of a petrous aneurysm treated with endovascular coils without compromising the ICA flow, and review the literature.

Keyword

Cerebral aneurysm; Subarachnoid hemorrhage; Endovascular treatment

MeSH Terms

Adolescent*
Aneurysm
Carotid Artery, Internal
Cerebral Arteries
Embolization, Therapeutic*
Emergencies
Headache
Humans
Intracranial Aneurysm
Magnetic Resonance Imaging
Male
Nausea
Neurofibromatoses*
Stents
Subarachnoid Hemorrhage
Tinnitus
Vomiting

Figure

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  Fig. 1 Neurofibromatosis.

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  Fig. 2 An approximately 1.5 cm-sized aneurysm located at the petrous portion of the internal cerebral artery on the left side is found on computed tomographic angiography (A) and magnetic resonance angiographic image (B) for cerebral artery.

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  Fig. 3 Bulbous enlargement of the transverse portion of the internal carotid artery on the left side suggests a large aneurysm with a broad neck in the magnetic resonance image of the cerebral artery.

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  Fig. 4 A large aneurysm located at the petrous portion of the internal cerebral artery on the left side is shown in the pre-treatment image of digital subtracted angiography (A), and the aneurysm is successfully and fully packed with multiple Guglielmi detachable coils (B) in the digital subtracted angiography.

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