A Rare Case of an Intracranial Aneurysm Arising from a Branch of the Occipital Artery

Introduction: True aneurysms of the occipital artery (OA) are, with only a few cases reported in the literature. The exact pathophysiology is unknown, and the presentation depends on the aneurysm location and rupture status. We present a case of a ruptured intracranial aneurysm arising from a branch of the occipital artery.

Objective: To describe a rare case of intracranial aneurysm arising from the retromastoid branch of the occipital artery.

Method: The patient is a 36-year-old male who presented with altered mental status after being assaulted. On exam, he was intubated with a Glasgow coma scale of 9. Imaging revealed a subdural hematoma of the posterior fossa and the cervical spine. He underwent suboccipital craniectomy with C1–5 laminectomy with the evacuation of the subdural hematoma ([Fig. 1]). Postoperative cerebral angiography revealed an intracranial aneurysm arising from the retro-mastoid branch of the occipital artery ([Fig. 2]). The aneurysm was embolized using platinum coils along with the parent vessel.

Result: The patient tolerated the procedure well. Also, the patient underwent craniocervical instrumented fusion to stabilize the craniovertebral junction. Eventually, the patient was discharged home with a modified Rankin scale of 2. No outpatient follow-up data available as the patient lost to follow-up.

Conclusion: Intracranial aneurysms of the occipital artery are extremely rare. Their etiology remains elusive, with some association with increased flow demand. No clear consensus concerning the management of these aneurysms. Both endovascular and or open surgical techniques can be used depending on the aneurysm characteristics, patient condition, and others.[1]-[3]

Fig. 1

Fig. 2

 

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• References

• Bissacco D, Domanin M, Romagnoli S, Martelli E, Civelli V, Gabrielli L. Spontaneous rupture of multiple occipital artery aneurysms in a patient with neurofibromatosis type 1. Vasc Endovascular Surg 2018; 52 (01) 86-88
• Chaudhry NS, Gaynor BG, Hussain S, Dernbach PD, Aziz-Sultan MA. Etiology and treatment modalities of occipital artery aneurysms. World Neurosurg 2017; 102: 697.e1-697.e4
• Gum GK, Numaguchi Y, Nadell JM, Robinson AE. Aneurysm of the occipital artery: development after surgical ligation of the internal carotid artery. AJNR Am J Neuroradiol 1987; 8 (06) 1155-1156

Publikationsverlauf

Artikel online veröffentlicht:
15. Februar 2022