Intranidal aneurysm

In some instances, complete cure is deemed impossible despite a combined technique. Partial treatment can yet be indicated in some cases (a) to cure a weak point of the AVM such as a false aneurysm, intranidal aneurysms, or large feeding artery aneurysms (Fig. 3.6) (b) to improve the clinical symptoms in case of a large AVM presenting with progressive neurologic deficits (Fox 1997). 

Partially targeted treatment (embolization) to eliminate risk factors of hleeding/rehleeding (feeding artery aneurysms, intranidal aneurysms, false aneurysms)... 

As outlined by Houdart et al. (1993), the depiction of intranidal aneurysms is difficult it is often performed at the time of superselective angiography. Moreover, true arterial intranidal aneurysms have to be distinguished from pseudoaneurysms, which are at the point of rupture of the nidus or of the venous drainage. 

Thus, we can postulate with Berenstein and Lasjaunias (1992) that intranidal aneurysms represent a weakness of the angioarchitecture and should influence treatment strategy. This is prohahly also true for other associated aneurysms. 

Marks MP, Lane B, Steinberg GK et al. (1992) Intranidal aneurysms in cerebral arteriovenous malformations evaluation and endovascular treatment. Radiology 183 355-360... 

---