Abstract
Aneurysms occurring during infundibular dilatation of the posterior communicating artery (PcomA ID) are relatively rare, and their details are unknown. In this study, we report the clinical and neuroradiological findings of five ruptured PcomA ID aneurysms.
Participants: We reviewed five cases of ruptured PcomA ID aneurysms treated in our department over the past 5 years.
Results: During the study period, 75 patients with ruptured aneurysms were treated with craniotomy clipping; the incidence of ruptured PcomA ID aneurysms was 6.7% (5/75 cases). All five cases involved female patients. Their ages ranged from 38–77 years (mean age, 55 years), with two patients in their 70s, one in her 40s, and two in their 30s, indicating a tendency for the disease to be more prevalent among relatively young people. The size of the PcomA ID aneurysms was 1.3–2.3 mm (average, 1.9 mm) in longitudinal diameter and 1.8-3.2 mm (average, 2.4 mm) in transverse diameter. The shape was a bleb-like aneurysm arising from part of the wall of the PcomA ID. All the aneurysms occurred in the distal curvature of the PcomA ID. This was presumably due to the pressure on the wall of the PcomA ID, the impingement force of blood flow, and shear stress.
Discussion: All patients were females, and PcomA ID aneurysms were more common in relatively young patients, as in previous reports. The average aneurysm size was 1.9 × 2.4 mm, indicating that even small bleb-like aneurysms occurring in the PcomA ID may rupture. Caution should be exercised when unruptured cases are encountered in routine clinical practice. Strict follow-up imaging is necessary in young female patients, and active rupture prevention treatments should be considered.
