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Presentation Number:EP - 34
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“There are no actual or potential conflicts of interes related to this presentation”
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ONCOTIC ANEURYSMS WITH CEREBRAL INFARCTIONS, CHRONIC ISCHEMIA AND
DEVELOPMENT OF SYNANGIOSIS
Institute of Neurosurgery Dr. Alfonso Asenjo Santiago. Chile
Neuroradiology Department
BRAVO E, RIVEROS R, SORDO J, RIVERA R
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Purpose
• To present a clinical case with oncotic aneurysms, cerebral infarctions, chronic ischemia and synangiosis.
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Case Report
• Female 53 yo
• Atrial myxoma in 2000
• Spontaneus subarachnoid hemorrhage in 2005
• Several catheter angiograms with multiple intracranial aneurysms.
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Multiple Intracranial Aneurysms (2D angiography)
Right Internal Carotid ArteryAP view
Right Internal Carotid ArteryLateral view
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Multiple Intracranial Aneurysms (2D angiography)
Left Internal Carotid ArteryAP view
Left Internal Carotid ArteryLateral view
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Multiple Intracranial Aneurysms (2D angiography)
Left Vertebral ArteryAP view
Left Vertebral ArteryLateral view
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Multiple Intracranial Aneurysms (3D rotational angiography)
Right Internal Carotid Artery Left Vertebral Artery
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Secuelar Brain Lesions(FLAIR)
CHRONIC ISCHEMIA?
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Synangiosis(Catheter Angiogram)
Right External Carotid Artery
SynangiosisSynangiosis
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Synangiosis(DynaCT)
Right External Carotid Artery
Synangiosis Synangiosis
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Putative Mechanism
AJNR Am J Neuroradiol 2001;22:1349-1352
ATRIAL MYXOMA
ONCOTIC ANEURYSMS
CHRONIC ISCHEMIA SYNANGIOSIS
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Putative Mechanism
Neurosci Lett 2006;409:118-123
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Conclusions
• This is the first clinical case reporting the presence of multiple oncotic aneurysms, brain ischemia and the development of synangiosis.
• Chronic ischemia is the trigger for developing synangiosis.
• Previously, it has been related the presence of myxomatous aneurysms and chronic ischemia.
AJNR Am J Neuroradiol 2001;22:1349-1352