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Presentation Number:EP - 34
“There are no actual or potential conflicts of interes related to this presentation”
ONCOTIC ANEURYSMS WITH CEREBRAL INFARCTIONS, CHRONIC ISCHEMIA AND
DEVELOPMENT OF SYNANGIOSIS
Institute of Neurosurgery Dr. Alfonso Asenjo Santiago. Chile
Neuroradiology Department
BRAVO E, RIVEROS R, SORDO J, RIVERA R
Purpose
• To present a clinical case with oncotic aneurysms, cerebral infarctions, chronic ischemia and synangiosis.
Case Report
• Female 53 yo
• Atrial myxoma in 2000
• Spontaneus subarachnoid hemorrhage in 2005
• Several catheter angiograms with multiple intracranial aneurysms.
Multiple Intracranial Aneurysms (2D angiography)
Right Internal Carotid ArteryAP view
Right Internal Carotid ArteryLateral view
Multiple Intracranial Aneurysms (2D angiography)
Left Internal Carotid ArteryAP view
Left Internal Carotid ArteryLateral view
Multiple Intracranial Aneurysms (2D angiography)
Left Vertebral ArteryAP view
Left Vertebral ArteryLateral view
Multiple Intracranial Aneurysms (3D rotational angiography)
Right Internal Carotid Artery Left Vertebral Artery
Secuelar Brain Lesions(FLAIR)
CHRONIC ISCHEMIA?
Synangiosis(Catheter Angiogram)
Right External Carotid Artery
SynangiosisSynangiosis
Synangiosis(DynaCT)
Right External Carotid Artery
Synangiosis Synangiosis
Putative Mechanism
AJNR Am J Neuroradiol 2001;22:1349-1352
ATRIAL MYXOMA
ONCOTIC ANEURYSMS
CHRONIC ISCHEMIA SYNANGIOSIS
Putative Mechanism
Neurosci Lett 2006;409:118-123
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