A giant dissecting aneurysm mimicking serpentine aneurysm angiographically- Case report and review of the literature

Intracranial dissecting and giant serpentine aneurysms are rare vascular an omalies. Their precise cause has not yet been completely clarified, and the radiological appearance of such lesions can be different in each case acco rding to the effect of hemodynamic stress on a pathologic vessel wall. For berry aneurysms, available evidence overwhelmingly favors their causation b y hemodynamically induced degenerative vascular disease and there is an obv ious need to determine the hemodynamic parameters most likely to induce the precursor atrophic lesions. In this study, a case of a giant dissecting an eurysm angiographically mimicking serpentine aneurysm of the right ophthalm ic artery is reported and the relevant literature is reviewed to investigat e the pathological characteristics and pathogenesis of this lesion. In the present case, radiological investigation of the lesion suggested a serpenti ne aneurysm, but the diagnosis was corrected to dissecting aneurysm subsequ ent to the pathological examination of the resected aneurysm. A giant dissecting aneurysm angiographically mimicking serpentine aneurysm and developing as the result of a circumferential dissection located betwee n the internal elastic lamina and media is of particular interest when the etiology of these aneurysms is considered. To our knowledge this is the fir st report on intracranial dissecting aneurysm mimicking serpentine aneurysm angiographically Our case illustrates the importance of careful serial sec tion studies for a better understanding of the vascular pathology underlyin g the processes involved in intracranial serpentine aneurysms. We conclude that serpentine, dissecting and berry aneurysms may all arise by way of sim ilar pathophysiological mechanisms.