Intraventricular aneurysms: Case reports and review of the literature

Background

Intraventricular aneurysms are rare, with only 49 cases have been reported to date in the literature. Treatment of these aneurysms is difficult because of their deep location, small size, and specific angioarchitecture.

Methods

We report four patients with intraventricular aneurysms. In the third patient, the aneurysm self-occluded during procedure of endovascular embolization, which has previously not been reported in the literature.

Results

The first patient was discharged without definitive treatment of his intraventricular aneurysm and died 1 year later. The third patient's aneurysm self-occluded during the procedure of endovascular embolization procedure. The aneurysms of the second and fourth patients were successfully embolized by coils and Onyx, respectively.

Conclusions

The conclusions drawn from our experience and a comprehensive review of the literature include the following: (1) intraventricular aneurysm should be considered in patients with isolated intraventricular hemorrhage; (2) intraventricular aneurysms are frequently very small (<5 mm diameter), and therefore, cannot always be detected on initial angiography; (3) small intraventricular aneurysms cannot usually be clipped or occluded without sacrificing the parent artery; (4) if an intraventricular aneurysm is identified, it should be treated by endovascular embolization or clipping rather than conservative treatment; (5) endovascular embolization should be the first treatment option, and craniotomy can also be considered.