Aneurysms of the proximal anterior cerebral artery (A1) are rare. We investigated the clinical and angiographical characteristics, and treatment outcomes of A1 aneurysms by reviewing a total of 989 cases of ruptured or unruptured cerebral aneurysms treated with surgical clipping or coil embolization in our department and identified 12 cases of A1 aneurysms (1.2%), including 4 ruptured and 8 unruptured aneurysms. Three of the 4 patients with ruptured aneurysm were
Vertex epidural hematoma EDH , which is an unusual consequence of head trauma, is characterized with manifold clinical course, so that the treatment strategy is still controversial. We describe three cases of vertex EDH with different clinical course. The first case was surgically treated because of slowly progressive neurological deterioration. The second case showed rapid improvement with spontaneous hematoma wash out. The third case was treated conservatively because of the absence of clinical symptoms despite compression of the superior sagittal sinus. Although several cases have been reported, clinical study with large number of cases is not available. Our cases showed typical but characteristic time courses, and hopefully they recall the further clinical interest to gain better understanding of the natural course of vertex EDH. The clinical course of patients with vertex EDH should be carefully observed to determine the appropriate timing of surgery.
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