Abstract
We investigated the prevalence and clinical significance of cerebral aneurysm cases that were associated with occlusion of the internal carotid artery (IC). We found 10 such patients (0.9%) among serial patients who were operated on by a senior neurosurgeon. All 3 cases with bilateral occlusion had aneurysms in the P1P2 junction. Cases with unilateral occlusion had a total of 10 aneurysms; 4 in the contralateral A1A2 junction, 3 in the basilar artery or P1P2 junction, 2 in the contralateral IC and 1 in the ipsilateral IC. Four of 11 patients (36%) with P1P2 junction aneurysm were combined with carotid artery occlusion. These findings strongly suggest that hemodynamic stress plays an important role in formation of those aneurysms. Though surgical outcome of those patients did not statistically differ from other patients without IC occlusion, hemodynamic compromise should be considered in treatment of such patients. Furthermore, in patients with occlusion of the major cerebral artery, incidental aneurysm should be taken into account.
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