Nakano Yoshiteru
   Department   School of Medicine  Neurosurgery, Clinical Medical Sciences
   Position  
Article types case reports
Language English
Peer review Peer reviewed
Title Surgical treatment for a ruptured true posterior communicating artery aneurysm arising on the fetal-type posterior communicating artery--two case reports and review of the literature.
Journal Formal name:Journal of UOEH
Abbreviation:J UOEH
ISSN code:0387821X/0387821X
Volume, Issue, Page 33(4),303-12頁
Author and coauthor Nakano Yoshiteru, Saito Takeshi, Yamamoto Junkoh, Takahashi Mayu, Akiba Daisuke, Kitagawa Takehiro, Miyaoka Ryo, Ueta Kunihiro, Kurokawa Toru, Nishizawa Shigeru
Publication date 2011/12
Summary Only a small number of aneurysms arising on the posterior communicating artery itself (true Pcom aneurysm) have been reported. We report two cases of ruptured true Pcom aneurysms with some characteristic features of true Pcom aneurysm. A 43 year old man suffering from subarachnoid hemorrhage (SAH) had an aneurysm arising on the fetal-type Pcom artery itself, and underwent surgery for clipping. Most of the aneurysm was buried in the temporal lobe, so retraction of the temporal lobe was mandatory. During the retraction, premature rupture was encountered. After tentative dome clipping and the control of bleeding, complete clipping was achieved. Another patient, a 71 year old woman presenting with consciousness disturbance due to SAH, had an aneurysm on the fetal-type Pcom artery itself, and underwent surgery for clipping. It has been generally considered that hemodynamic factor plays an important role in the formation, the growth, and the rupture of the cerebral aneurysm. This factor is especially significant in true Pcom aneurysm formation and rupture. According to the literature, a combination of fetal type Pcom and formation of the true Pcom aneurysm has been reported in most cases (81.8%). Most of the aneurysm can be buried in the temporal lobe, and the retraction of the temporal lobe during the dissection of the neck would be necessary, which causes premature rupture of the true Pcom aneurysm. In the surgery for a true Pcom aneurysm, we should be aware of possible premature rupture when temporal lobe retraction is necessary.
PMID 22259835