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Twin-like appearance of an unruptured intracerebral anterior communicating artery (ACom) aneurysm in a male sibling of a patient with a ruptured ACom aneurysm


Fierstra, Jorn; Burkhardt, Jan Karl; Stamou, Stamatios; Regli, Luca; Bozinov, Oliver (2016). Twin-like appearance of an unruptured intracerebral anterior communicating artery (ACom) aneurysm in a male sibling of a patient with a ruptured ACom aneurysm. Acta Neurochirurgica, 158(6):1051-1055.

Abstract

BACKGROUND: Increased risk of intracranial aneurysm rupture with subsequent subarachnoid haemorrhage (SAH) is related to several possible factors, including first-grade familial aneurysms. METHODS AND RESULTS: Here we present a case of one ruptured and one unruptured identical twin-like anterior communicating artery (ACom) aneurysm present in two male siblings, without any proven genetic predisposition. According to evidence-based scores, aneurysm rupture risk for the younger (51 years old) sibling (with an unruptured ACom aneurysm) would be low, leaving the decision for either treatment or clinical follow-up to the discretion of the treating physician. CONCLUSIONS: From a clinical neurosurgical perspective, however, especially since his older brother suffered an aneurysmal SAH at age 57 (i.e. 6 life-years later) from a twin-like-appearing ACom aneurysm, in our opinion rupture seems almost inevitable, thus prompting treatment at an early stage.

Abstract

BACKGROUND: Increased risk of intracranial aneurysm rupture with subsequent subarachnoid haemorrhage (SAH) is related to several possible factors, including first-grade familial aneurysms. METHODS AND RESULTS: Here we present a case of one ruptured and one unruptured identical twin-like anterior communicating artery (ACom) aneurysm present in two male siblings, without any proven genetic predisposition. According to evidence-based scores, aneurysm rupture risk for the younger (51 years old) sibling (with an unruptured ACom aneurysm) would be low, leaving the decision for either treatment or clinical follow-up to the discretion of the treating physician. CONCLUSIONS: From a clinical neurosurgical perspective, however, especially since his older brother suffered an aneurysmal SAH at age 57 (i.e. 6 life-years later) from a twin-like-appearing ACom aneurysm, in our opinion rupture seems almost inevitable, thus prompting treatment at an early stage.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurosurgery
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Anterior communicating artery aneurysm; Familial; Rupture risk; Subarachnoid haemorrhage
Language:English
Date:2016
Deposited On:23 Nov 2016 15:48
Last Modified:08 Dec 2017 20:56
Publisher:Springer
ISSN:0001-6268
Publisher DOI:https://doi.org/10.1007/s00701-016-2782-8
PubMed ID:27038167

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