Cerebral Aneurysms with Internal Carotid Artery Agenesis: A Unique Case Similar to Moyamoya Disease and Literature Review

Internal carotid artery (ICA) agenesis/aplasia is occasionally accompanied with cerebral aneurysms caused by hemodynamic stress. If the aneurysms are located around the circle of Willis, they are managed with clipping or coil embolization. Herein, we report a case of ICA agenesis with perforating ar...

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Bibliographic Details
Published in:Neurologia medico-chirurgica 2021, Vol.61(5), pp.321-333
Main Authors: TAKAMIYA, Soichiro, YOSHIMOTO, Tetsuyuki, MARUICHI, Katsuhiko
Format: Article
Language:English
Subjects:
Aneurysm
Aneurysms
Aplasia
Cardiovascular system
Carotid arteries
Carotid artery
Case reports
cerebral aneurysm
Embolization
Endovascular coiling
Epidemiology
internal carotid artery agenesis
Literature reviews
Moyamoya disease
Original
revascularization
Surgery
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Description
Summary:Internal carotid artery (ICA) agenesis/aplasia is occasionally accompanied with cerebral aneurysms caused by hemodynamic stress. If the aneurysms are located around the circle of Willis, they are managed with clipping or coil embolization. Herein, we report a case of ICA agenesis with perforating artery aneurysms treated successfully with revascularization. Moreover, a literature review of ICA agenesis with cerebral aneurysms was performed to compare with the current case. We conducted a literature review using data from PubMed. A secondary search was also performed by reviewing the references of each article previously searched. In our case, the aneurysms shrank and disappeared after direct and indirect bypass surgeries, and indirect bypass developed as in moyamoya disease (MMD). The epidemiological and clinical features of aneurysms accompanied with ICA agenesis were identified via a literature review. Aneurysms with ICA agenesis categorized as type F based on the Lie classification system, or referred to as rete mirabile, are occasionally located in an untreatable site; hence, they cannot be treated with clipping or coil embolization. Moreover, results showed that previous studies did not use revascularization for the treatment of aneurysm. In conclusion, if an aneurysm with ICA agenesis is difficult to approach directly or via an endovascular procedure, revascularization can be a treatment option.
ISSN:0470-8105
1349-8029
DOI:10.2176/nmc.oa.2020-0358