INTRACRANIAL ANEURYSM ASSOCIATED WITH AORTIC COARCTATION. Z.Jamaleddine,S.ElHaddad , A.J. El Quessar , N.El Abbadi *, R.Ajaja **, Y.Chikhaoui ** Department of neuroradiology , neurochirurgy *, cardiovascular chirurgy ** Hospital cheikh Zaid Rabat Morocco. NR6. INTRODUCTION.
Z.Jamaleddine,S.ElHaddad, A.J. El Quessar, N.ElAbbadi*, R.Ajaja**, Y.Chikhaoui**
Department of neuroradiology, neurochirurgy*, cardiovascular chirurgy**
Hospital cheikhZaid Rabat Morocco
Axial computed tomography (CT) without enhancement: Subarachnoid hemorrhage of the skull base citerns( ), the right lateral sulcus ( ).
Angio-CT reformat : Anterior communicating artery aneurysm
Angio-CT with 3D reconstruction : descending aortic coarctation
Surgical treatment was recommended at the beginning of the aneurysm and after 3 weeks for aortic coarctation,
Favorable improvement after 4 weeks were shown.
The association between AI and CA has been reported for the first time by Eppinger 1871.
The average age of discovery = 25 years old,
This combination increase the risk of aneurysm rupture. This complication can occur many years even after surgical treatment of CA.
The anterior communicating artery is the most affected (48%)
An hypothesis considering this association as a result of an embryological anomaly of the crest neurale has no real scientific foundation.
However, the positive diagnosis of CA is often established at the stage of complications (heart failure, bacterial endocarditis, aortic dissection or cerebrovascular complications).
The selection of the indication surgery between AI and CA is controversial .
However, the AI has to be made first, given the risk of rupture in the presence of a CA.
The association AI and CA is a rare disease of adolescents and young adults.
Its pathogenesis related to abnormal embryonic neural crest has no scientific basis.
A cardiovascular examination seems necessary well-conducted systematic in any young subject carries an intracranial aneurysm.