Characteristics of aneurysms arising from the horizontal portion of the anterior cerebral artery

A 50-year-old man presented with an aneurysm arising from a fenestration of horizontal portion (A 1 ) of the anterior cerebral artery manifesting as subarachnoid hemorrhage. Coil embolization was conducted and the aneurysm was occluded easily. Most reported cases of these types of aneurysms underwent direct surgery. Aneurysm arising from the A 1 fenestration is rare, but the present case shows that coil embolization can be an effective treatment modality. Three-dimensional rotational angiography and aneurysmography were helpful to characterize this complicated vascular structure.

Section: Introductionmentioning

confidence: 99%

Endovascular Repair of Ruptured Aneurysm Arising From Fenestration of the Horizontal Segment of the Anterior Cerebral Artery

Yoshida

Ezura

Sasaki

et al. 2012

“…7,15,18,19) Most aneurysms at the A 1 portion are formed at the origin of perforators. 15,19) Aneurysm has also occurred at variations of the ACA, for example, fenestrated A 1 , accessory middle cerebral artery (MCA), duplicated MCA, and azygos ACA. 15,19) Accessory MCA is defined as originating from the ACA and duplicating the MCA that originates from the internal carotid artery (ICA).…”

Section: Introductionmentioning

confidence: 99%

“…15,19) Aneurysm has also occurred at variations of the ACA, for example, fenestrated A 1 , accessory middle cerebral artery (MCA), duplicated MCA, and azygos ACA. 15,19) Accessory MCA is defined as originating from the ACA and duplicating the MCA that originates from the internal carotid artery (ICA). 16) Accessory MCA is rare and is found in 0.3-2.7% of autopsy cases 1) and 0.24-0.34% of patients undergoing angiography.…”

Section: Introductionmentioning

confidence: 99%

Ruptured Anterior Cerebral Artery Aneurysm at the Origin of the Accessory Middle Cerebral Artery -Case Report-

Wakabayashi

Hori

Kondoh

et al. 2011

A 36-year-old female patient was admitted to our hospital with a rare case of aneurysm at the origin of the accessory middle cerebral artery (MCA) manifesting as severe headache and vomiting. Neurological examination did not detect any abnormalities or consciousness disturbance. Computed tomography demonstrated diffuse subarachnoid hemorrhage. Magnetic resonance angiography showed an aneurysm in the horizontal portion of the left anterior cerebral artery (A 1 ). Digital subtraction angiography and three-dimensional digital subtraction angiography demonstrated a saccular aneurysm originating at the junction of the left A 1 and accessory MCA. Another accessory MCA originated at the proximal portion of the left A 2 without an aneurysm. Two accessory MCAs were found on the left. Neck clipping was performed via a left pterional approach. One month after admission, she was discharged without neurological deficits.

“…Therefore, this lesion should be isolated from the cerebral circulation with preservation of any perforator and blood flow through intact brain vessels. 10,12,15,29,32) Fusiform aneurysm is often associated with severe atherosclerotic change in other intracranial vessels. Postnatal aggravating factors, such as hypertension and arteriosclerosis, are important in the induction of saccular aneurysms in rats and monkeys.…”

Section: Discussionmentioning

confidence: 99%

“…20) The incidence of proximal ACA (A 1 segment) aneurysms is reported to be 0.76-3.4%, often in cases of vascular anomalies complicated by aneurysms and cases of multiple aneurysms, and mostly of saccular type. 3,5,7,10,12,18,27,28,32) We encountered a case of fusiform aneurysm of the A 1 segment which was treated by trapping.…”

Section: Introductionmentioning

confidence: 99%

Ruptured Fusiform Aneurysm of the Proximal Anterior Cerebral Artery (A1 Segment) -Case Report-

Aoki¹,

Nemoto²,

Yokota

et al. 2007

A 42-year-old man presented with a ruptured fusiform aneurysm of the proximal anterior cerebral artery (A 1 segment) manifesting as sudden onset of severe headache. Brain computed tomography revealed subarachnoid hemorrhage in the basal cisterns, and left carotid angiography demonstrated a fusiform aneurysm of the left A 1 segment. He underwent surgery via the left pterional approach. The left A 1 segment exhibited a fusiform configuration. Adequate development of the anterior communicating artery was confirmed. Trapping of the aneurysm was performed. The aneurysm was associated with atherosclerotic changes. The postoperative course was uneventful, and the patient was discharged without neurological deficits 1 month after surgery. Fusiform aneurysm of the A 1 segment is quite rare, and tends to bleed, so must be treated. The atherosclerotic origin indicates long-term follow up to identify subsequent lesions.