Surgical Treatment of Intracranial Anterior Ethmoidal Aneurysm: Case Report, Literature Review, and Surgical Video

Thomas M. Zervos, Thet Mg Mg, Hesham Zakaria, Kyi Hlaing, Tin Htun Aung, Win Myaing, Jack Rock

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Anterior ethmoid aneurysms are rare with 5 cases of intracranial rupture and 3 cases of life-threatening epistaxis described in recent literature. We present a case of an intracranial ruptured anterior ethmoid aneurysm treated surgically with a favorable outcome. Case Description: A 64-year-old male presenting with a headache was found to have a right frontal intracranial hemorrhage with an associated 1.5 cm length × 1.8 cm maximal width anterior ethmoidal artery aneurysm. No definitive etiology of the aneurysm was identified. The aneurysm was treated using a bifrontal craniotomy with interhemispheric microdissection, clip ligation, and resection of the aneurysm dome for pathologic analysis, which ruled out a mycotic etiology. He recovered uneventfully and returned to work with no identifiable neurologic deficit. Conclusions: Consistent with prior reports, an intracranial, anterior ethmoidal artery aneurysm can occur in isolation without an associated vascular malformation. On the basis of a literature review and this case, surgical ligation is considered effective and possibly superior over endovascular treatment due to the risk of injury to the orbital vascular supply with transarterial treatment.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalWorld neurosurgery
Volume136
DOIs
StatePublished - Apr 2020
Externally publishedYes

Keywords

  • Anterior ethmoidal artery aneurysm
  • Intracranial hemorrhage
  • Operative video

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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