An azygos anterior cerebral artery (ACA) is a rare variant of normal embryogenesis in which confluence of two A1 segments results in a single A2 segment with the absence of anterior communicating artery. The occurrence of an aneurysm at the bifurcation of azygos ACA is rare with few cases reported in the literature. We report a case of a 40-year-old lady who presented with subarachnoid hemorrhage following rupture of a giant, saccular distal azygos ACA aneurysm. Bifrontal craniotomy and clipping of an aneurysm was performed. The clinical significance of azygos ACA and surgical strategies in clipping these aneurysms are discussed with a review of literature.
24 years female patient was referred from gynaecology department as a case of mass in pelvis. She was initially investigated for primary infertility in same department. Ultrasonography of abdomen was suggestive of teratoma. Contrast enhanced CT scan of abdomen and pelvis was suggestive of anterior sacral meningocele with scimitar sacral deformity. CT scan findings were confirmed by MRI. Patient underwent excision of anterior meningocele via posterior trans-sacral approach. Intraoperatively, we found huge dermoid cyst within meningocele. Findings latter on confirmed by histopathology. Postoperatively patient recovered without any complications and was discharged on day 10.
INTRODUCTION: Brain herniations have been labelled as 'Brain Code' to signify the emergent need for diagnosis and intervention. Traumatic
Brain Injury is the most common cause of brain herniation which could be lateral, subfalcine, descending transtentorial, tonsillar, upward or
transcalvarial.
CASE: Three cases of descending transtentorial herniation,their imaginary and their operative intervention are discussed.
DISCUSSION: The clinical features and the previous works on descending transtentorial herniation are discussed in brief.
CONCLUSION: In conclusion, the three cases discussed had a rapid resolution of symptoms after surgical intervention.
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