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Angiographic doughnut-shaped aneurysm of intracranial internal carotid artery

  • Case Report - Vascular
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Abstract

Morphologic characteristics of angiographic doughnut-shaped aneurysms of the intracranial internal carotid artery (ICA) have been rarely reported in the literature and were discussed only radiologically. In this case, surgical clipping was performed, and the specimen from the aneurysm was examined to correlate the pathologic findings and morphologic characteristics. A 59-year-old male presented with diffuse subarachnoid hemorrhage secondary to a ruptured vascular lesion originating from the intracranial portion of the right ICA. Digital subtraction angiography showed a 1.5-cm doughnut-shaped aneurysm at the junction of the ICA and the posterior communicating artery. The aneurysm was successfully clipped in a neurosurgical hybrid operating room. The pathologic findings of the content inside the aneurysm revealed only fibrinoid exudates, materials from thrombosis. This is the first report to prove that the mechanism of a doughnut-shaped aneurysm formation is central thrombosis inside the aneurysm, possibly related to its complex hemodynamic flow.

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Acknowledgements

We thank Hong-Hsin Lin, Shih-Ruei Huang, and Meng-Ju Lee for their technical assistance in the neurosurgical hybrid operating suite in Taichung Veterans General Hospital.

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Authors and Affiliations

  1. Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan, Republic of China

    Chung-Hsin Lee, Chih-Hsiang Liao, Hsu-Tung Lee & Yuang-Seng Tsuei

  2. Department of Neurosurgery, Tri-service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China

    Chung-Hsin Lee, Hsu-Tung Lee & Yuang-Seng Tsuei

  3. Department of Neuroradiology, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China

    Wen-Hsien Chen

Authors
  1. Chung-Hsin Lee
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  2. Chih-Hsiang Liao
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  3. Wen-Hsien Chen
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  4. Hsu-Tung Lee
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  5. Yuang-Seng Tsuei
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Corresponding author

Correspondence to Yuang-Seng Tsuei.

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The patient /next of kin/guardian has consented to the submission of the case report for submission to the journal.

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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None of the authors received funding for this study/manuscript.

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Highlights

1. This is the first report to prove that the mechanism of a doughnut-shaped aneurysm formation is central thrombosis.

2. The mechanism of formation is different in a doughnut-shaped aneurysm and a giant serpentine aneurysm.

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Lee, CH., Liao, CH., Chen, WH. et al. Angiographic doughnut-shaped aneurysm of intracranial internal carotid artery. Acta Neurochir 159, 721–724 (2017). https://doi.org/10.1007/s00701-017-3110-7

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  • DOI: https://doi.org/10.1007/s00701-017-3110-7

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