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(Stroke. 1995;26:1945-1949.)
© 1995 American Heart Association, Inc.

Articles

Spontaneous Thrombosis of an Unruptured Anterior Communicating Artery Aneurysm

An Unusual Cause of Ischemic Stroke

Richard D. Brownlee, MD; Bruce I. Tranmer, MD; Robert J. Sevick, MD; Grigory Karmy, MD Bernadette J. Curry, MD

From the Departments of Clinical Neurosciences (R.D.B., B.I.T., R.J.S., G.K., B.J.C.), Radiology (R.J.S.), Pathology (G.K., B.J.C.), and the Division of Neurosurgery (R.D.B., B.I.T.), University of Calgary, Foothills Hospital, Calgary, Alberta, Canada.

Correspondence to Richard D. Brownlee, MD, Division of Neurosurgery, 1206-3031 Hospital Drive NW, Calgary, Alberta, Canada T2N 4T8.

Background Stroke caused by spontaneous thrombosis of an unruptured intracranial aneurysm is a rare event.

Case Description A 66-year-old woman experienced a transient ischemic attack and cerebral infarctions due to spontaneous thrombosis of an unruptured anterior communicating artery aneurysm. Extension of thrombus into both anterior cerebral arteries and the left middle cerebral artery, resulting in ischemic infarction in all three vascular territories, was diagnosed by CT scanning, MRI, and cerebral angiography and confirmed at autopsy.

Conclusions This case illustrates a rare complication of an unruptured saccular aneurysm with neuroimaging and pathological correlation. Morphological and hemodynamic factors that may have precipitated aneurysm thrombosis are discussed with reference to experimental models.

Key Words: aneurysm • cerebral ischemia, transient • pathology • thrombosis

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