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Case Reports
. 2020 Oct 30;16(1):48-50.
doi: 10.1016/j.radcr.2020.10.012. eCollection 2021 Jan.

Treatment of a middle cerebral artery aneurysm in the setting of Loeys-Dietz syndrome: Case report and review of literature

Ee Shern Liang  1 , Kate Mahady  2   3 , Alan Coulthard  2   3 , Craig Winter  1   3
Affiliations
Case Reports

Treatment of a middle cerebral artery aneurysm in the setting of Loeys-Dietz syndrome: Case report and review of literature

Ee Shern Liang et al. Radiol Case Rep. .

Erratum in

Abstract

Loeys-Dietz syndrome (LDS) is a connective tissue disorder with associated systemic vasculopathies including intracranial arterial aneurysm formation and dissections. LDS is a relatively less well-known entity compared with other connective tissue disorders, such as Ehlers-Danlos or Marfan syndrome, and consequently experience in the management of the associated intracranial aneurysms is suboptimal. We present a case of surgical clipping of a middle cerebral artery aneurysm in a patient with LDS. A 46-year-old female with LDS (type III) was found to have a right middle cerebral artery (MCA) bifurcation aneurysm following vascular screening. The decision was made to surgically clip the aneurysm after consultation in our neurovascular multidisciplinary team meeting. A standard right pterional craniotomy was performed and the aneurysm was secured with 2 straight Sugita clips. The temporal M2 branch was noted to be thin walled and this prompted application of the second tandem clip, rather than risk re-positioning the initial clip. In our case, the MCA aneurysm neck was robust enough to take a clip without any complications, and therefore we suggest that the presence of LDS is not an absolute contra-indication to perform open craniotomy and clipping.

Keywords: Cerebral aneurysm; Connective tissue disorder; Endovascular management; Loeys-Dietz syndrome; Surgical clipping.

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Figures

Fig 1
Fig. 1
Digital subtraction angiography: posterior view of 5 mm right MCA bifurcation aneurysm.
Fig 2
Fig. 2
Digital subtraction angiography: post clipping.
See this image and copyright information in PMC

References

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