Parent Artery Occlusion for Symptomatic Large Internal Carotid Artery Aneurysm with Primitive Trigeminal Artery Variant: A Case Report

Ryohei Ono; Masayuki Sato; Sho Okune; Tenyu Hino; Taisuke Akimoto; Yoshiro Ito; Aiki Marushima; Mikito Hayakawa; Eiichi Ishikawa; Yuji Matsumaru

doi:10.5797/jnet.cr.2022-0029

CASE REPORTS

Parent Artery Occlusion for Symptomatic Large Internal Carotid Artery Aneurysm with Primitive Trigeminal Artery Variant: A Case Report

Ryohei Ono, Masayuki Sato, Sho Okune, Tenyu Hino, Taisuke Akimoto, Yoshiro Ito, Aiki Marushima, Mikito Hayakawa, Eiichi Ishikawa, Yuji Matsumaru

Author information

Ryohei Ono
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Masayuki Sato
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Sho Okune
Division of Stroke Prevention and Treatment, Faculty of Medicine University of Tsukuba, Tsukuba, Ibaraki, Japan
Tenyu Hino
Division of Stroke Prevention and Treatment, Faculty of Medicine University of Tsukuba, Tsukuba, Ibaraki, Japan
Taisuke Akimoto
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Yoshiro Ito
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Aiki Marushima
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Mikito Hayakawa
Division of Stroke Prevention and Treatment, Faculty of Medicine University of Tsukuba, Tsukuba, Ibaraki, Japan
Eiichi Ishikawa
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Yuji Matsumaru
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Division of Stroke Prevention and Treatment, Faculty of Medicine University of Tsukuba, Tsukuba, Ibaraki, Japan

Keywords: primitive trigeminal artery variant, cerebral aneurysm, balloon occlusion test, parent artery occlusion

JOURNAL OPEN ACCESS

2023 Volume 17 Issue 1 Pages 22-26

DOI https://doi.org/10.5797/jnet.cr.2022-0029

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Abstract

Objective: To report a case of symptomatic large cerebral aneurysm of the internal carotid artery (ICA), associated with a primitive trigeminal artery variant (PTAv), which was treated with a balloon occlusion test (BOT) to evaluate ischemic tolerance.

Case Presentation: A 79-year-old woman was diagnosed with a symptomatic large cerebral aneurysm of the ICA bifurcating the PTAv due to diplopia. After confirming the ischemic tolerance of the perfusion area and PTAv by BOT, we performed ICA parent artery occlusion with selective embolization of the PTAv. Postoperative MRI showed no ischemic lesion and the diplopia was resolved.

Conclusion: ICA parent artery occlusion with PTAv selective embolization after evaluation by BOT is useful in the treatment of large aneurysms.

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