Ruptured A3 segment aneurysm in a patient with neurofibromatosis type 1: a case report and literature review
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By
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Fang Xue
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Fei Xie
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Jianqiang Hao
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Sen He
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June 25, 2026
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Clinical Scorecard: A Case Study of A3 Segment Aneurysm Rupture in a Neurofibromatosis Type 1 Patient: Review of Existing Literature
At a Glance
| Category | Detail |
|---|
| Condition | Neurofibromatosis Type 1 with A3 Segment Aneurysm |
| Key Mechanisms | Abnormal proliferation of vascular smooth muscle cells, dysregulation of the Ras signaling pathway, secondary endothelial dysfunction. |
| Target Population | Patients with Neurofibromatosis Type 1 and cerebrovascular complications. |
| Care Setting | Neurosurgical and interventional radiology settings. |
Key Highlights
- Ruptured distal ACA aneurysms in NF1 are rare, with fewer than 20 cases reported.
- Endovascular coil embolization was successfully performed, achieving complete aneurysm occlusion.
- Long-term follow-up indicated progression of moyamoya syndrome and emergence of a new aneurysm.
Guideline-Based Recommendations
Diagnosis
- Diagnosis of NF1 based on clinical features and revised diagnostic criteria.
Management
- Endovascular coil embolization is a safe and effective first-line treatment for ruptured distal ACA aneurysms.
Monitoring & Follow-up
- Indefinite vascular surveillance is warranted due to the progressive nature of NF1-associated cerebrovascular disease.
Risks
- Risk of severe neurological disability or death following aneurysm rupture.
Patient & Prescribing Data
Adults with Neurofibromatosis Type 1 presenting with cerebrovascular complications.
Endovascular coil embolization provides long-term protection from rebleeding.
Clinical Best Practices
- Adopt a tailored, multidisciplinary approach in managing NF1-related cerebrovascular complications.
- Ensure lifelong monitoring for new lesions in patients with NF1.
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