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Complex Neurosurgical Case Study on Oncotic Aneurysms and Chronic Ischemia

Explore a clinical case of a 53-year-old female with multiple oncotic aneurysms, cerebral infarctions, chronic ischemia, and synangiosis development. This presentation discusses the unique diagnostic process, imaging findings, and treatment strategies for this complex neurovascular condition.

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Complex Neurosurgical Case Study on Oncotic Aneurysms and Chronic Ischemia

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  1. Presentation Number:EP - 34

  2. “There are no actual or potential conflicts of interes related to this presentation”

  3. Institute of Neurosurgery Dr. Alfonso Asenjo Santiago. Chile Neuroradiology Department • ONCOTIC ANEURYSMS WITH CEREBRAL INFARCTIONS, CHRONIC ISCHEMIA AND DEVELOPMENT OF SYNANGIOSIS BRAVO E, RIVEROS R, SORDO J, RIVERA R

  4. Purpose • To present a clinical case with oncotic aneurysms, cerebral infarctions, chronic ischemia and synangiosis.

  5. Case Report • Female 53 yo • Atrial myxoma in 2000 • Spontaneus subarachnoid hemorrhage in 2005 • Several catheter angiograms with multiple intracranial aneurysms.

  6. Multiple Intracranial Aneurysms (2D angiography) Right Internal Carotid Artery AP view Right Internal Carotid Artery Lateral view

  7. Multiple Intracranial Aneurysms (2D angiography) Left Internal Carotid Artery AP view Left Internal Carotid Artery Lateral view

  8. Multiple Intracranial Aneurysms (2D angiography) Left Vertebral Artery AP view Left Vertebral Artery Lateral view

  9. Multiple Intracranial Aneurysms (3D rotational angiography) Right Internal Carotid Artery Left Vertebral Artery

  10. Secuelar Brain Lesions(FLAIR) CHRONIC ISCHEMIA?

  11. Synangiosis(Catheter Angiogram) Synangiosis Synangiosis Right External Carotid Artery

  12. Synangiosis(DynaCT) Synangiosis Synangiosis Right External Carotid Artery

  13. Putative Mechanism ATRIAL MYXOMA ONCOTIC ANEURYSMS CHRONIC ISCHEMIA SYNANGIOSIS AJNR Am J Neuroradiol 2001;22:1349-1352

  14. Putative Mechanism Neurosci Lett 2006;409:118-123

  15. Conclusions • This is the first clinical case reporting the presence of multiple oncotic aneurysms, brain ischemia and the development of synangiosis. • Chronic ischemia is the trigger for developing synangiosis. • Previously, it has been related the presence of myxomatous aneurysms and chronic ischemia. AJNR Am J Neuroradiol 2001;22:1349-1352

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