Surgical Management of a Ruptured Posterior Choroidal Intraventricular Aneurysm Associated with Moyamoya Disease Using Frameless Stereotaxy: Case Report and Review of the Literature

M. Jafer Ali, Bernard Bendok, Christopher C. Getch, Numa R. Gottardi-Littell, Stefan Mindea, H. Hunt Batjer, Michael Stoffman, Murat Gunel, Sam P. Javedan, Robert F. Spetzler, Daniel L. Barrow, Christopher S. Ogilvy

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

OBJECTIVE AND IMPORTANCE: Prevention of rebleeding is the most important aspect of the management of hemorrhagic moyamoya disease, because rebleeding causes significant morbidity and mortality. CLINICAL PRESENTATION: A 26-year-old male patient with a history of moyamoya disease since the age of 3 years and multiple strokes was in a semicomatose state at presentation. He was found to have intraventricular and periventricular hemorrhages abutting the atrium of the right ventricle. His hospital course was complicated by a second hemorrhage. Both bleeding events were believed to be secondary to a ruptured right lateral posterior choroidal aneurysm. INTERVENTION: The aneurysm was excised and revealed histopathology consistent with a true saccular aneurysm. Frameless stereotactic guidance was used during surgery to minimize damage to collateral vessels and to shorten the surgical corridor. CONCLUSION: The management of hemorrhagic moyamoya disease should be modified based on the source of hemorrhage and its relation to a specifically located aneurysm. In the case of aneurysms arising from the choroidal artery, the general belief is that most of these represent pseudoaneurysms and have a tendency to regress spontaneously. Because of the rebleeding risk, we recommend early intervention in treating ruptured intracranial aneurysms using the least invasive surgical techniques.

Original languageEnglish (US)
Pages (from-to)1019-1024
Number of pages6
JournalNeurosurgery
Volume54
Issue number4
StatePublished - Apr 2004
Externally publishedYes

Fingerprint

Neuronavigation
Moyamoya Disease
Aneurysm
Hemorrhage
faropenem medoxomil
Ruptured Aneurysm
False Aneurysm
Intracranial Aneurysm
Heart Ventricles
Arteries
Stroke
Morbidity
Mortality

Keywords

  • Choroidal artery aneurysm
  • Intracranial hemorrhage
  • Moyamoya disease
  • Periventricular aneurysm
  • Rebleeding

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Surgical Management of a Ruptured Posterior Choroidal Intraventricular Aneurysm Associated with Moyamoya Disease Using Frameless Stereotaxy : Case Report and Review of the Literature. / Ali, M. Jafer; Bendok, Bernard; Getch, Christopher C.; Gottardi-Littell, Numa R.; Mindea, Stefan; Batjer, H. Hunt; Stoffman, Michael; Gunel, Murat; Javedan, Sam P.; Spetzler, Robert F.; Barrow, Daniel L.; Ogilvy, Christopher S.

In: Neurosurgery, Vol. 54, No. 4, 04.2004, p. 1019-1024.

Research output: Contribution to journalArticle

Ali, MJ, Bendok, B, Getch, CC, Gottardi-Littell, NR, Mindea, S, Batjer, HH, Stoffman, M, Gunel, M, Javedan, SP, Spetzler, RF, Barrow, DL & Ogilvy, CS 2004, 'Surgical Management of a Ruptured Posterior Choroidal Intraventricular Aneurysm Associated with Moyamoya Disease Using Frameless Stereotaxy: Case Report and Review of the Literature', Neurosurgery, vol. 54, no. 4, pp. 1019-1024.
Ali, M. Jafer ; Bendok, Bernard ; Getch, Christopher C. ; Gottardi-Littell, Numa R. ; Mindea, Stefan ; Batjer, H. Hunt ; Stoffman, Michael ; Gunel, Murat ; Javedan, Sam P. ; Spetzler, Robert F. ; Barrow, Daniel L. ; Ogilvy, Christopher S. / Surgical Management of a Ruptured Posterior Choroidal Intraventricular Aneurysm Associated with Moyamoya Disease Using Frameless Stereotaxy : Case Report and Review of the Literature. In: Neurosurgery. 2004 ; Vol. 54, No. 4. pp. 1019-1024.
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