{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:11:35Z","timestamp":1770351095945,"version":"3.49.0"},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"12","license":[{"start":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T00:00:00Z","timestamp":1710720000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,18]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Carotid occlusion often leads to the formation of a collateral network. On rare occasions, due to hemodynamic influence, aneurysms can occur. Here, the authors describe a 69-year-old male presenting with intracerebral hemorrhage secondary to a ruptured aneurysm within such a network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The patient presented to the emergency department with an altered level of consciousness. Imaging showed a left temporal lobe hemorrhage extending into the ventricle, subdural hematoma, and evidence of contrast extravasation. Digital subtraction angiography revealed an occluded left internal carotid artery with the left middle cerebral artery territory reconstituted by flow through an external carotid artery\u2013internal carotid artery anastomosis. The latter was formed by the superficial temporal artery\u2013superior orbital artery, as well as pial-pial collaterals from the posterior temporal artery. Notably, a 4-mm aneurysm arising from the pial-pial collateral network was identified. Surgical intervention involved a left temporal craniectomy and aneurysm excision, with special attention paid to preserving the anastomotic flow through the superficial temporal artery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This case underscores the importance of recognizing and preserving collateral vascular pathways in cases of carotid occlusion with an associated aneurysm. It emphasizes the necessary balance between managing aneurysm risk and maintaining cerebral perfusion, highlighting the need for careful preoperative planning and intraoperative caution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case2454","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T15:14:44Z","timestamp":1710774884000},"source":"Crossref","is-referenced-by-count":0,"title":["Ruptured pial-pial collateral aneurysm associated with left internal carotid artery occlusion: nuances of surgical management. Illustrative case"],"prefix":"10.3171","volume":"7","author":[{"given":"Juan Silvestre G","family":"Pascual","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences, Project NeuroArm, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada"},{"name":"Department of Clinical Neurosciences, Section of Neurosurgery, University of Calgary, Calgary, Alberta, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eddie","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Project NeuroArm, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Runze","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Section of Neurosurgery, University of Calgary, Calgary, Alberta, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristopher D","family":"Langdon","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanju","family":"Lama","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Project NeuroArm, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada"},{"name":"Department of Clinical Neurosciences, Section of Neurosurgery, University of Calgary, Calgary, Alberta, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Garnette R","family":"Sutherland","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Project NeuroArm, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada"},{"name":"Department of Clinical Neurosciences, Section of Neurosurgery, University of Calgary, Calgary, Alberta, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Curr Cardiol Rev","first-page":"279","article-title":"Cerebral collateral circulation in carotid artery disease","volume":"5","author":"Romero JR","year":"2009","unstructured":"Romero JR, Pikula A, Nguyen TN, Nien YL, Norbash A, Babikian VL. 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Endovascular management of a collateral network aneurysm in a patient with spontaneous internal carotid artery occlusion. Interv Neuroradiol. 2015;21(2):175\u2013177."},{"issue":"1","key":"b4","series-title":"Int Angiol","first-page":"16","article-title":"The critical role of the external carotid artery in cerebral perfusion of patients with total occlusion of the internal carotid artery","volume":"31","author":"Dalainas I","year":"2012","unstructured":"Dalainas I, Avgerinos ED, Daskalopoulos ME, . The critical role of the external carotid artery in cerebral perfusion of patients with total occlusion of the internal carotid artery. Int Angiol. 2012;31(1):16\u201321."},{"issue":"1","key":"b5","series-title":"Surg Neurol","first-page":"4","article-title":"Ruptured cerebral aneurysms associated with arterial occlusion","volume":"20","author":"Matsuda M","year":"1983","unstructured":"Matsuda M, Handa J, Saito A, Matsuda I, Kamijyo Y. 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Dangerous extracranial-intracranial anastomoses and supply to the cranial nerves: vessels the neurointerventionalist needs to know. AJNR Am J Neuroradiol. 2009;30(8):1459\u20131468."},{"issue":"1","key":"b15","series-title":"Neurosurg Focus","first-page":"E11","article-title":"The biophysical role of hemodynamics in the pathogenesis of cerebral aneurysm formation and rupture","volume":"47","author":"Soldozy S","year":"2019","unstructured":"Soldozy S, Norat P, Elsarrag M, . The biophysical role of hemodynamics in the pathogenesis of cerebral aneurysm formation and rupture. Neurosurg Focus. 2019;47(1):E11."},{"issue":"1","key":"b16","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Endothelial dysfunction in cerebral aneurysms","volume":"47","author":"Sheinberg DL","year":"2019","unstructured":"Sheinberg DL, McCarthy DJ, Elwardany O, . Endothelial dysfunction in cerebral aneurysms. 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Curr Cardiol Rev. 2009;5(4):279\u2013288."},{"issue":"4","key":"b2","series-title":"Neurosurg Rev","first-page":"517","article-title":"Aneurysms associated with non-moyamoya collateral arterial networks: report of three cases and review of literature","volume":"34","author":"Rodr\u00edguez-Hern\u00e1ndez A","year":"2011","unstructured":"Rodr\u00edguez-Hern\u00e1ndez A, Lu DC, Miric S, Lawton MT. Aneurysms associated with non-moyamoya collateral arterial networks: report of three cases and review of literature. Neurosurg Rev. 2011;34(4):517\u2013522."},{"issue":"2","key":"b3","series-title":"Interv Neuroradiol","first-page":"175","article-title":"Endovascular management of a collateral network aneurysm in a patient with spontaneous internal carotid artery occlusion","volume":"21","author":"Kaya B","year":"2015","unstructured":"Kaya B, Erdi F, Keskin F, Kalkan E, Ko\u00e7 O. Endovascular management of a collateral network aneurysm in a patient with spontaneous internal carotid artery occlusion. Interv Neuroradiol. 2015;21(2):175\u2013177."},{"issue":"1","key":"b4","series-title":"Int Angiol","first-page":"16","article-title":"The critical role of the external carotid artery in cerebral perfusion of patients with total occlusion of the internal carotid artery","volume":"31","author":"Dalainas I","year":"2012","unstructured":"Dalainas I, Avgerinos ED, Daskalopoulos ME, . The critical role of the external carotid artery in cerebral perfusion of patients with total occlusion of the internal carotid artery. Int Angiol. 2012;31(1):16\u201321."},{"issue":"1","key":"b5","series-title":"Surg Neurol","first-page":"4","article-title":"Ruptured cerebral aneurysms associated with arterial occlusion","volume":"20","author":"Matsuda M","year":"1983","unstructured":"Matsuda M, Handa J, Saito A, Matsuda I, Kamijyo Y. 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Cerebrovasc Dis. 2005;20(1):1\u20135."},{"issue":"1","key":"b11","series-title":"Surg Neurol","first-page":"58","article-title":"Spontaneous middle cerebral artery occlusion leading to moyamoya phenomenon and aneurysm formation on collateral arteries","volume":"55","author":"Seki Y","year":"2001","unstructured":"Seki Y, Fujita M, Mizutani N, Kimura M, Suzuki Y. Spontaneous middle cerebral artery occlusion leading to moyamoya phenomenon and aneurysm formation on collateral arteries. Surg Neurol. 2001;55(1):58\u201362."},{"issue":"8","key":"b12","series-title":"No Shinkei Geka","first-page":"727","article-title":"A case of spontaneous middle cerebral artery occlusion associated with a cerebral aneurysm angiographically disappearing after STA-MCA anastomosis","volume":"25","author":"Takahashi M","year":"1997","unstructured":"Takahashi M, Fujimoto T, Suzuki R, Asai J, Miyo T, Hokaku H. 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