====== Anterior communicating artery aneurysm clinical features ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1XCi2Dznx-zIY-_N5IElrERW9pev9fy5VkZ4d_eXSSmN3QwUK3/?limit=15&utm_campaign=pubmed-2&fc=20231017053637}}

[[Anterior communicating artery aneurysm]]s are usually silent until they rupture.

Suprachiasmatic pressure may cause altitudinal [[visual field]] deficits, [[abulia]] or [[akinetic mutism]], [[amnesia]], or [[hypothalamic dysfunction]].

Neurologic deficits in aneurysmal rupture may reflect [[intraventricular hemorrhage]] (79%), [[brain hemorrhage]] (63%), acute [[hydrocephalus]] (25%), or [[frontal lobe sign]]s (20%).

May also present with [[diabetes insipidus]] (DI) or other [[hypothalamic dysfunction]].

===== Visual symptoms =====

see [[Anterior Communicating Artery Aneurysm Visual Symptoms]]


===== Hyponatremia =====
Sayama et al. studied the incidence and timing of [[hyponatremia]] (Na < 135 mEq l-1) after subarachnoid hemorrhage (SAH) with special reference to ruptured anterior communicating artery (A-com) aneurysms. Hunt and Kosnik (HK) grading, symptomatic vasospasm in A-com aneurysm, and hydrocephalus were analyzed for connections to hyponatremia in 55 patients with ruptured A-com aneurysms, 65 with ruptured internal cerebral artery (ICA) aneurysms, and 49 with ruptured middle cerebral artery (MCA) aneurysms. Hyponatremia occurred in 28 (51%) of 55 patients with A-com aneurysms and in nine (18%) of 49 patients with MCA aneurysms. Severe hyponatremia (Na < 130 mEq l-1) occurred in 16 patients (29%) in the A-com group, four patients (6%) in the ICA group, and three patients (6%) in the MCA group. The A-com aneurysm group had a significantly higher incidence of mild hyponatremia (p < 0.01) and severe hyponatremia (p < 0.001) than other groups. Among A-com cases, hyponatremia occurred significantly more often in HK grade III and IV cases (p < 0.05), in cases with vasospasm (p < 0.001), and in cases with hydrocephalus (p < 0.01). Respective days of onset for symptomatic vasospasm and for hyponatremia were day 7.6 +/- 4.4 and day 10.6 +/- 5.8 following SAH, representing a 3-day delay for hyponatremia (p < 0.05). In most patients hyponatremia resolved within 28 days following SAH. Hyponatremia occurred more often with A-com aneurysms, possibly because of vasospasm around the A-com or hydrocephalus causing hypothalamic dysfunction. Since hypervolemic therapy can cause hyponatremia, particularly careful observation is required during such therapy in patients with A-com aneurysm
((Sayama T, Inamura T, Matsushima T, Inoha S, Inoue T, Fukui M. High incidence
of hyponatremia in patients with ruptured anterior communicating artery
aneurysms. Neurol Res. 2000 Mar;22(2):151-5. PubMed PMID: 10763501.
)).

===== Amnesia =====
Talland et al reported in 1967 a amnesic syndrome with anterior communicating artery aneurysm
((Talland GA, Sweet WH, Ballantine HT Jr. Amnesic syndrome with anterior
communicating artery aneurysm. J Nerv Ment Dis. 1967 Sep;145(3):179-92. PubMed
PMID: 6066072.
)).

===== References =====