Internal Capsule Infarction after Neurointervention in Ruptured Anomalous Anterior Choroidal Artery Aneurysm

초록

Introduction : The anterior choroidal artery (AchA) is an important cerebral artery, despite its small size, because it provides blood supply to several important structures. Some complications related to procedures have reported in the rare cases of anomalies of the origin of the AchA. Material and Method : A 35-year-old man presented with severe headache and loss of consciousness. Brain computed tomography (CT) scan revealed subarchnoid hemorrhage in basal cistern, and laterally projecting aneurysm on left internal carotid artery (ICA). The aneurysm was originated in anomalous hypertrophic AchA, and posterior communicating artery (Pcom) was located in the proximal portion in conventional angiography. Results : Coil embolization was performed, aneruysm was nearly obliterated, and hypertrophic AchA was saved completely. The patient showed motor aphasia and hemiplegia immediately after neurointervention. Diffusion magnetic resonance (MR) revealed acute infarction in left posterior limb of internal capsule and some thalamic area. Conclusions : The clinical significance of the anomalous hypertrohic AchA comes from higher incidence of intracranial aneurysm other than normal AchoA. The subtle injury of the artery may result in severe complication, because it has many small choroidal branches.