Abstract
Objective: We report a case of severe memory impairment after coil embolization for multiple cerebral aneurysms including a ruptured internal carotid (IC)-anterior choroidal artery aneurysm with hypoplastic posterior communicating artery.
Case presentation: A 34-year-old right-handed man suffered a sudden headache and was admitted to our hospital. Subarachnoid hemorrhage due to a ruptured aneurysm was diagnosed. Coil embolization of three cerebral aneurysms including an IC-anterior choroidal artery aneurysm was performed. After surgery, he had neither motor paresis nor sensory disturbance, but showed disorientation and both retrograde and anterograde amnesia. Although immediate recall and remote memory were almost intact, his recent memory was moderately impaired and his verbal and non-verbal memories were completely impaired. Brain magnetic resonance imaging revealed cerebral infarcts in the genu of the right internal capsule and splenium of the corpus callosum, and so on. We believe that memory impairment was because of damage to the Papez circuit with temporary interruption of the anterior choroidal artery.
Conclusion: Coil embolization for IC-anterior choroidal artery aneurysm may cause memory impairment because the thalamotuberal artery arises from the anterior choroidal artery in this case, and because temporary interruption of this artery damaged the Papez circuit directly. Therefore, we should pay attention to temporary interruption of the posterior communicating artery and anterior choroidal artery caused by coils or thromboembolic events.
