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Spontaneous Regression Of Unruptured Small Intracranial Aneurysm Associated With Proximal Parent Artery Stenosis

Endo, H. 2024Other/Unknown

Endo, H., Honjo, K., Ono, H., Ishikawa, K., & Nakamura, H. (2024). Spontaneous regression of unruptured small intracranial aneurysm associated with proximal parent artery stenosis. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 10.1007/s10072-024-07966-y. Advance online publication. https://doi.org/10.1007/s10072-024-07966-y

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Abstract

Spontaneous thrombosis of intracranial aneurysms is rare. Spontaneous regression of unruptured small saccular aneurysms is even more rare. A 76-year-old woman with a history of hypertension and dyslipidemia was referred for evaluation of an unruptured intracranial aneurysm. Magnetic resonance angiography showed a left internal carotid artery aneurysm with a maximum width of 4.0 mm and a neck diameter of 3.0 mm. She was monitored using annual magnetic resonance angiography. Imaging at the 8.5-year follow-up showed partial aneurysm regression and stenosis in the parent artery proximal to the aneurysm. The next year, it had almost completely regressed. Spontaneous regression can occur even with unruptured small intracranial aneurysms. In our patient, proximal parent artery stenosis may have played a role.

Case Details

Disease Location

Internal carotid artery

Personal Characteristics

76-year-old woman, history of hypertension, dyslipidemia, hypothyroidism, and breast cancer

Clinical Characteristics

Diagnosed with an unruptured intracranial aneurysm. Mra performed 4 months after diagnosis showed a left saccular internal carotid artery (ica) aneurysm with maximum width and neck diameters of 4.0 and 3.0 mm. Intra-aneurysmal thrombosis or stenosis in the parent artery were visualized.

Remission Characteristics

At the 8.5-year follow-up, partial aneurysm regression and ica stenosis immediately proximal to the aneurysm were observed. One year later, the aneurysm had almost completely regressed

Treatment & Mechanisms

Proposed Remission Mechanisms

Parent artery stenosis may have contributed to the aneurysm’s regression.