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Toader C, Covache-Busuioc RA, Bratu BG, Corlatescu AD, Popa AA, Ciurea AV. Kissing Aneurysms of the Anterior Communicating Artery Treated With Surgical Clipping: A Case Report and Literature Review. Cureus 2024; 16:e60824. [PMID: 38910700 PMCID: PMC11190632 DOI: 10.7759/cureus.60824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2024] [Indexed: 06/25/2024] Open
Abstract
Intracranial "kissing" aneurysms are rare vascular conditions described as two anatomically adjacent aneurysms originating from either the same or different arteries, with their walls pressed together. Two-dimensional angiography was formerly considered the gold standard for diagnosis, with the three-dimensional rotational type now offering more insightful details about vascular discrepancies. The treatment of anterior communicating artery (AcoA) "kissing" aneurysms poses significant challenges, with surgical clipping proving difficult due to their deep midline location or the bilateral anterograde arterial supply. However, advancements in endovascular coil embolization, such as dual-volume reconstruction, can assist in diagnosis. This study presents the case of a 50-year-old patient who was diagnosed with "kissing" aneurysms of the AcoA. The patient underwent surgical clipping and showed no pathological follow-up findings. The surgical intervention often provides a more direct and effective approach. This case contributes to the body of knowledge surrounding the management of this complex disease.
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Affiliation(s)
- Corneliu Toader
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU
- Department of Neurosurgery, National Institute of Neurology and Neurovascular Diseases, Bucharest, ROU
| | | | - Bogdan-Gabriel Bratu
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU
| | | | - Andrei Adrian Popa
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU
| | - Alexandru Vladimir Ciurea
- Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU
- Department of Neurosurgery, Sanador Clinical Hospital, Bucharest, ROU
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Singh DK, Sharma PK, Singh AK, Chand VK. Ruptured mirror DACA aneurysm: A rare case report and review of literature. J Cerebrovasc Endovasc Neurosurg 2023; 25:340-346. [PMID: 36647234 PMCID: PMC10555628 DOI: 10.7461/jcen.2023.e2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 10/16/2022] [Accepted: 11/07/2022] [Indexed: 01/18/2023] Open
Abstract
Bilateral distal anterior cerebral artery (DACA) aneurysms also called "kissing aneurysms" or "mirror aneurysm" are extremely rare, accounting for only 0.2% of all intracranial aneurysms. There have only been a few examples of mirror DACA aneurysms reported in the literature. Here, we report a rare case of mirror DACA aneurysm in a middle aged female with its successful clipping. Patient was admitted with severe headache and altered sensorium. Computed tomography (CT) head was suggestive of anterior inter-hemispheric hematoma. Digital subtraction angiography (DSA) was done which was suggestive of two distal anterior cerebral artery aneurysms located at same anatomical position. It was treated through microsurgical clipping. Mirror image DACA aneurysms are rare occurrence. All patients with ruptured DACA aneurysms should have angiography with 3D reconstruction studies. This aids in determining the aneurysm's morphology and planning treatment accordingly.
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Affiliation(s)
- Deepak Kumar Singh
- Department of Neurosurgery, DR. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
| | - Prevesh Kumar Sharma
- Department of Neurosurgery, DR. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
| | - Arun Kumar Singh
- Department of Neurosurgery, DR. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
| | - Vipin Kumar Chand
- Department of Neurosurgery, DR. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
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Fu CY, Chen JL, Liu ZH, Wang PC, Duan CZ, Zhao JN. Kissing aneurysms of the distal anterior cerebral artery: A case report and literature review. Exp Ther Med 2018; 15:3471-3476. [PMID: 29616086 DOI: 10.3892/etm.2018.5854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/01/2017] [Indexed: 11/06/2022] Open
Abstract
Intracranial 'kissing' aneurysms are rare types of multiple aneurysms referring to two adjacent aneurysms arising from identical or different arteries with separate origins and partially adherent walls. The present study reported a 54-year-old female patient, who was identified with a 'kissing' aneurysm in the A3 segment of the bilateral anterior cerebral arteries, as demonstrated by head computed tomography and emergency cerebral digital subtraction angiography analysis. In total, 12 days following the clipping of the aneurysms, the patient was discharged with a Modified Rankin Scale=0 and recovered well with no neurological deficits. Based on previous literature, it was indicated that the majority of patients with 'kissing' aneurysm have a good prognosis and the cure rate is as high as 96.8%. However, the recovery rate may not be that high as the sample size is not large enough to thoroughly demonstrate the complete prognosis of 'kissing' aneurysms.
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Affiliation(s)
- Chuan-Yi Fu
- Department of Neurosurgery, The National Key Clinic Specialty, Hainan General Hospital, Hainan Clinical Medicine Research Institution, Haikou, Hainan 570311, P.R. China
| | - Jian-Long Chen
- Department of Neurosurgery, The National Key Clinic Specialty, Hainan General Hospital, Hainan Clinical Medicine Research Institution, Haikou, Hainan 570311, P.R. China
| | - Zhao-Hui Liu
- Department of Neurosurgery, The National Key Clinic Specialty, Hainan General Hospital, Hainan Clinical Medicine Research Institution, Haikou, Hainan 570311, P.R. China
| | - Peng-Cheng Wang
- Department of Neurosurgery, The National Key Clinic Specialty, Hainan General Hospital, Hainan Clinical Medicine Research Institution, Haikou, Hainan 570311, P.R. China
| | - Chuan-Zhi Duan
- Department of Neurosurgery, The National Key Clinic Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510282, P.R. China
| | - Jian-Nong Zhao
- Department of Neurosurgery, The National Key Clinic Specialty, Hainan General Hospital, Hainan Clinical Medicine Research Institution, Haikou, Hainan 570311, P.R. China
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