AB040. A complication of recurrent artery of Huebner infarction after resection of an anterior cerebral artery thrombotic giant intracranial aneurysm: case report and literature review
Abstract

AB040. A complication of recurrent artery of Huebner infarction after resection of an anterior cerebral artery thrombotic giant intracranial aneurysm: case report and literature review

Kuan-Hao Fu1, Pin-Yuan Chen1,2, Jiun-Lin Yan1,3

1Department of Neurosurgery, Keelung Chang Gung Memorial Hospital, Keelung; 2College of Medicine, Chang Gung University, Taoyuan; 3School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan

Correspondence to: Kuan-Hao Fu, MD. Department of Neurosurgery, Keelung Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung. Email: how250@gmail.com.

Background: Giant aneurysms, comprising 3–5% of all intracranial aneurysms, pose a considerable challenge due to their heterogeneity and complex vascular anatomy. Defined as aneurysms exceeding 2.5 cm in diameter, they often develop intraluminal thrombosis. Despite advancements in neurosurgical techniques, managing giant aneurysms remains complex and highly individualized. Thrombotic giant aneurysms are particularly problematic due to their size and thrombosis potential. This case report is unique as it presents the first documented instance of recurrent artery of Heubner (RAH) infarction following surgical resection of a giant thrombotic aneurysm.

Case Description: A 53-year-old man with no prior systemic presented to our emergency department due to progressive left-sided weakness and slurred speech. Magnetic resonance imaging (MRI) of brain revealed a thrombotic giant intracranial aneurysm on right anterior cerebral artery (ACA). Surgical resection was performed using a right pterional craniotomy. During surgery, the aneurysm was confirmed to be completely thrombosed and was excised. Postoperatively, the patient experienced a generalized seizure and was intubated. Brain MRI revealed a new infarction in the RAH territory. Despite initial complications, the patient showed significant recovery with rehabilitation, regaining most motor functions by the 6-month follow-up.

Conclusions: This case emphasizes the critical importance of comprehensive preoperative evaluation, particularly in assessing small perforating branches and collateral circulation. It highlights the challenges in managing giant aneurysms and the necessity of anticipating potential postoperative complications. This report adds valuable insights into the clinical management and surgical planning for giant aneurysms, particularly those involving the ACA and RAH.

Keywords: Thrombotic giant intracranial aneurysm; recurrent artery of Heubner infarction (RAH infarction); surgical resection; case report

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cco.amegroups.com/article/view/10.21037/cco-24-ab040/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committees and with the Helsinki Declaration (as revised in 2013). Written informed consent was obtained from the patient for publication of this case report and accompanying images.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Cite this abstract as: Fu KH, Chen PY, Yan JL. AB040. A complication of recurrent artery of Huebner infarction after resection of an anterior cerebral artery thrombotic giant intracranial aneurysm: case report and literature review. Chin Clin Oncol 2024;13(Suppl 1):AB040. doi: 10.21037/cco-24-ab040

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