This Article Order Full text via Infotrieve Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by O'Boynick, P. Articles by Pietak, R. Search for Related Content PubMed PubMed Citation Articles by O'Boynick, P. Articles by Pietak, R.

Stroke, Vol 25, 2283-2286, Copyright © 1994 by American Heart Association

ARTICLES

Aneurysm of the left middle cerebral artery caused by myxoid degeneration of the vessel wall

P O'Boynick, KD Green, S Batnitzky, JJ Kepes and R Pietak
Department of Surgery (Section of Neurosurgery), University of Kansas College of Health Sciences and Hospital, Kansas City 66160-7410.

BACKGROUND: Myxoid degeneration of arterial walls may result in dissection and dissecting aneurysms in extracranial and intracranial portions of cerebral arteries. Rarely, saccular aneurysms may also develop on that basis, but thus far these have only been reported in the cervical portions of the carotid arteries. We describe a case of a nondissecting aneurysm of the left middle cerebral artery caused by myxoid degeneration of the media. CASE DESCRIPTION: A 39-year-old man had acute onset of frontal headache and neck stiffness. Computed tomographic scan and lumbar puncture established the presence of subarachnoid hemorrhage. Angiography demonstrated a left middle cerebral artery aneurysm. This was clipped and the wall biopsied. Microscopically the entire thickness of the vascular wall showed marked myxoid alterations. No dissection was present. The patient had an uneventful recovery. CONCLUSIONS: This observation confirms that myxoid degeneration of arterial walls may cause aneurysms with eventual rupture even in the absence of dissection. Rare cases of this type of aneurysm have been reported to occur in the cervical portions of the carotid arteries, but this is the first reported observation of such changes involving an intracerebral artery.