INTRACRANIAL ANEURYSMS ASSOCIATED WITH AORTITIS SYNDROME - CASE-REPORT AND REVIEW OF THE LITERATURE

OBJECTIVE AND IMPORTANCE: Aortitis syndrome is a systemic vasculitis o f unknown etiology, affecting mainly the major branches of the aorta a nd leading to stenosis or occlusion. Intracranial aneurysms are rarely associated with this syndrome. Only 15 cases have been previously rep orted. CLINICAL PRESENTATION: A 54-year-old woman with a 10-year histo ry of aortitis syndrome demonstrated nonruptured cerebral aneurysms in the left internal carotid and anterior communicating arteries, with d ecreased flow in the right internal carotid artery and ipsilateral Al segment. INTERVENTION: The patient underwent clipping of the aneurysms through a left pterional craniotomy and transsylvian approach. CONCLU SION: In our review of 16 reported cases, including the present case ( 13 with ruptured aneurysms and 3 with nonruptured aneurysms), there we re 25 saccular aneurysms, and we noted the following clinical characte ristics: 1) patient age was 26 to 64 years, with an average of 50.2 ye ars; 2) aneurysms arose predominantly along the course of collateral f low, especially in the vertebrobasilar system (13 of 25 aneurysms, 52. 0%); 3) there was a high incidence of multiplicity (7 of 16 cases, 43. 8%). These characteristics suggest that increased hemodynamic stress, produced by stenosis or occlusion of the major branches of the aorta a nd systemic hypertension, plays an important role in the development o f cerebral aneurysms in patients with this syndrome.