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Coarctation of the Aorta as a Rare Indirect Cause of Aneurysmal Subarachnoid Hemorrhage in the Adolescent: A Case Report and Review of the Literature
Aneurysmal subarachnoid hemorrhage (SAH) is rare in teenagers. We present the case of a 19-year-old woman with an aneurysmal SAH and four anterior circulation aneurysms. Due to the urgency of operative treatment, no initial conventional cerebral angiography was performed. The CT angiography depicted the aortic arch incompletely. The coarctation was discovered on day 5 after ictus in a cerebral angiography for vasospasm surveillance. We believe that in young SAH patients without an explainable predilection for aneurysm formation, imaging of the aortic arch during the initial CT angiography, not to miss a coarctation of the aorta, is highly recommended.
The report was conceptualized and drafted by M.V. All the authors were involved in the formulation and correction of the manuscript. M.V. created the illustrations, and all the authors approved the final manuscript.
This case report was written with the full informed consent of the patient and her family.
Received: 30 January 2020
Accepted: 22 April 2020
Article published online:
14 February 2021
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- 1 van Gijn J, Kerr RS, Rinkel GJ. Subarachnoid haemorrhage. Lancet 2007; 369 (9558): 306-318
- 2 Dodel R, Winter Y, Ringel F. et al. Cost of illness in subarachnoid hemorrhage: a German longitudinal study. Stroke 2010; 41 (12) 2918-2923
- 3 Dijkema EJ, Leiner T, Grotenhuis HB. Diagnosis, imaging and clinical management of aortic coarctation. Heart 2017; 103 (15) 1148-1155
- 4 Connolly HM, Huston III J, Brown Jr RD, Warnes CA, Ammash NM, Tajik AJ. Intracranial aneurysms in patients with coarctation of the aorta: a prospective magnetic resonance angiographic study of 100 patients. Mayo Clin Proc 2003; 78 (12) 1491-1499
- 5 LeBlanc FE, Charrette EP, Dobell AR, Branch CL. Neurological complications of aortic coarctation. Can Med Assoc J 1968; 99 (07) 299-303
- 6 Bjorkesten GA. Coarctation of the aorta and subarachnoid hemorrhage. Duodecim 1955; 71 (1–2): 213-216
- 7 Punsar S, Seppala T. Aneurysms of the cerebral artery and subacachnoid hemorrhage in coarctation of aorta. Duodecim 1956; 72 (05) 404-408
- 8 Hüdaoğlu O, Kurul S, Cakmakci H, Men S, Yiş U, Dirik E. Aorta coarctation presenting with intracranial aneurysm rupture. J Paediatr Child Health 2006; 42 (7–8): 477-479
- 9 Kim ST, Brinjikji W, Lanzino G, Kallmes DF. Neurovascular manifestations of connective-tissue diseases: a review. Interv Neuroradiol 2016; 22 (06) 624-637
- 10 Schievink WI, Link MJ, Piepgras DG, Spetzler RF. Intracranial aneurysm surgery in Ehlers-Danlos syndrome type IV. Neurosurgery 2002; 51 (03) 607-611 , discussion 611–613
- 11 Lall RR, Eddleman CS, Bendok BR, Batjer HH. Unruptured intracranial aneurysms and the assessment of rupture risk based on anatomical and morphological factors: sifting through the sands of data. Neurosurg Focus 2009; 26 (05) E2
- 12 Natraj Setty HSS, Shivanand P, Narendhiran P. et al. Coarctation of aorta presenting as spontaneous subarachnoid hemorrhage in a young female: a case report of a rare clinical entity. Cardiol Res 2019; 10 (04) 241-244
- 13 Zhang H, Feng L. Coarctation of the aorta complicated with intracranial aneurysm: a case report and literature review. World Neurosurg 2018; 112: 25-30
- 14 Tomar GS, Goyal K, Chandran R, Luthra A, Chauhan V, Kumar N. Aneurysmal hemorrhage in a pregnant patient with coarctation of aorta: an anesthetic challenge. J Clin Anesth 2017; 37: 176-178
- 15 Nakae R, Fujiki Y, Yokobori S, Naoe Y, Yokota H. Subarachnoid aneurysmal hemorrhage associated with coarctation of the aorta: case report and review of the literature. J Nippon Med Sch 2017; 84 (04) 186-192
- 16 Benyounes N, Blanc R, Boissonnet H, Piotin M. Subarachnoid hemorrhage revealing aortic coarctation in a young man. Neuroradiology 2011; 53 (11) 931-932
- 17 Helbok R, Beer R, Chemelli A. et al. Multimodal neuromonitoring in a patient with aneurysmal subarachnoid hemorrhage associated with aortic coarctation. Neurocrit Care 2011; 14 (03) 433-437
- 18 Mercado R, López S, Cantú C. et al. Intracranial aneurysms associated with unsuspected aortic coarctation. J Neurosurg 2002; 97 (05) 1221-1225
- 19 Sibley E, Doroshow RW, Milliken JC, Anand SK. Subarachnoid hemorrhage and isolated atresia of the aortic arch. J Emerg Med 2002; 22 (02) 179-183
- 20 Serizawa T, Satoh A, Miyata A. et al. Ruptured cerebral aneurysm associated with coarctation of the aorta: report of two cases. Neurol Med Chir (Tokyo) 1992; 32 (06) 342-345
- 21 Fukuda H, Sako K, Yonemasu Y. Coarctation of the descending aorta with aneurysm of the anterior communicating artery. Surg Neurol 1985; 23 (04) 380-382