Anatomic Features of Distal Anterior Cerebral Artery Aneurysms

Lehečka, Martin; Porras, Matti; Dashti, Reza; Niemelä, Mika; Hernesniemi, Juha

doi:10.1227/01.neu.0000310695.44670.32

Cited by 58 publications

(62 citation statements)

References 49 publications

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“…5,6,[8][9][10]17) Detailed clinical courses were described in six of the previous cases, 5,[8][9][10]17) and the present case, as listed in Table 1. Two of the aneurysms were unruptured and five were ruptured.…”

Section: Discussionmentioning

confidence: 76%

“…Recently, the anatomic features of distal ACA aneurysms of the entire postcommunicating segments were described with a detailed angiographic analysis of 101 patients. 6) The size of the distal ACA aneurysms appeared to depend on rupture status, as ruptured aneurysms were larger than unruptured ones, with mean sizes of 7.4 mm and 4.2 mm, respectively. Thus, the size of the reported accessory ACA aneurysms seems similar to that of typical distal ACA aneurysms.…”

Section: Discussionmentioning

confidence: 91%

“…3,6,18,20) The median artery of the corpus callosum (MACC), a median branch of the triplicated ACA originating from anterior communicating artery, supplies the septal nuclei, septum pellucidum, and upper portion of the column of the fornix. If the MACC develops and gives rise to the usual cortical branches of the ACA in addition to supplying the above-mentioned areas, it is defined as an accessory ACA.…”

Section: Introductionmentioning

confidence: 99%

“…9) This mechanism would also account for the frequent occurrence of accessory ACA aneurysm on the A 4 or A 5 segments, whereas 78.2% to 85.7% of distal ACA aneurysms are generally located on the A 3 segment of the ACA. 3,6) In contrast, the A 4 and A 5 segments harbor only 6% to 7.6% of distal ACA aneurysms. 3,6,14) Distal ACA aneurysms are associated with not only anomalous ACAs but also other anomalies including vascular malformations and aneurysms.…”

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confidence: 99%

“…3,6) In contrast, the A 4 and A 5 segments harbor only 6% to 7.6% of distal ACA aneurysms. 3,6,14) Distal ACA aneurysms are associated with not only anomalous ACAs but also other anomalies including vascular malformations and aneurysms. 3,6,18,20) Accessory ACA aneurysms appear to be less frequently associated with other vascular abnormalities.…”

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confidence: 99%

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Ruptured Distal Accessory Anterior Cerebral Artery Aneurysm -Case Report-

Matsuzaki

Uno

Fujihara

et al. 2011

Neurol. Med. Chir.(Tokyo)

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A 48-year-old man presented with an extremely rare aneurysm arising from an accessory anterior cerebral artery (ACA) manifesting as sudden onset of headache lasting for 5 days. Neurological examination on admission revealed no abnormalities. Computed tomography showed subarachnoid hemorrhage of the interhemispheric fissure and intraparenchymal hematoma of the left cingulate gyrus. Magnetic resonance and cerebral angiography revealed a saccular aneurysm of the distal portion of the accessory ACA classified as the bihemispheric type. Neck clipping of the aneurysm was performed via an interhemispheric approach 17 days after symptom onset. The patient made a good postoperative recovery without neurological deficit. Distal accessory ACA aneurysms tend to arise from the first bifurcation and supply parietal branches. The aneurysms tend to occur on the bihemispheric type of distal accessory ACA. Hemodynamic stress may contribute to formation or development of these aneurysms.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Ruptured Distal Accessory Anterior Cerebral Artery Aneurysm -Case Report-

Matsuzaki

Uno

Fujihara

et al. 2011

Neurol. Med. Chir.(Tokyo)

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Three‐dimensional morphometry of the A2 segment of the anterior cerebral artery with neurosurgical relevance

Żurada¹,

Gielecki²,

Tubbs

et al. 2010

Clinical Anatomy

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Most prior morphometry data regarding the A2 segment of the anterior cerebral artery (ACA) have been based on cadaveric measurements. With newer imaging modalities, surgical techniques, and minimally invasive procedures, new standards for the anatomy of this vessel are necessary. A novel computer-based data system was used to analyze the three-dimensional (3D) morphometry of 230 A2 segments. In addition, tortuosity (TI) and deviation indices (DI) for this segment were calculated. The mean internal diameter of the A2 segment was 1.86 mm, and segments tended to be larger in men and on left sides. A2 segments were asymmetrical in 43%, and this was more common in women. Lengths tended to be greater on right sides and in men. Volumes were greater in men and increased with age, which was statistically significant. These gender differences were found to be statistically significant (P < 0.05), for both volume and diameter. TI was equal among sides, but DI was more often greater on right sides. The correlation coefficient ratio for length and DI was statistically significant. It is important to understand various 3D morphometrical differences particularly between genders. By constructing blood flow simulation models and during revascularization procedures, surgeons are able to gain a better understanding of each patient's vascular anatomy. These additional 3D data regarding the anatomy of the postcommunicating parts of the ACA may be useful to the neurosurgeon and interventional neuroradiologist. These data may assist with an earlier diagnosis of pathologies affecting the 3D morphology of the ACA.

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