Saccular bilobed aneurysm of an azygos anterior cerebral artery

Jagetia, Anita; Kumar, Pratap N.; Sinha, Shalini; Sharma, Ajay

doi:10.1016/j.jocn.2006.02.005

Cited by 14 publications

(26 citation statements)

References 8 publications

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“…Furthermore, ruptured DACA aneurysms have a high incidence of accompanying IPH. 3,5,8,[11][12][13]15,18,[20][21][22]25,26,31,32) Those characteristics were thought to be unfavorable for endovascular therapy. 10) Although surgical clipping is considered as the primary treatment, it is difficult when comparing with other anterior circulation aneurysms because of the narrow operative field, protection of bridge veins, and interhemispheric adhesions.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Efficacy of Endovascular Therapy for Ruptured Distal Anterior Cerebral Artery Aneurysms

Oishi

Nonaka

Yamamoto

et al. 2013

Neurol. Med. Chir.(Tokyo)

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Surgical clipping has been the primary treatment option for ruptured distal anterior cerebral artery (DACA) aneurysms. Therefore, the literature on endovascular therapy is sparse. The present study investigated the feasibility and efficacy of endovascular therapy for ruptured DACA aneurysms in 31 patients, 26 females and 5 males (mean age 63.2 ± 12.6 years). Mean aneurysm size and neck width were 4.8 ± 2.3 mm and 2.2 ± 0.7 mm, respectively. The Hunt and Hess (H/H) grades just prior to the treatment were scored as H/H grades 1-3 in 20 patients and H/H grades 4-5 in 11 patients. Fifteen patients had an intraparenchymal hematoma (IPH) surrounding the ruptured aneurysm on the initial computed tomography. Overall, 22 patients had a modified Rankin scale (mRS) score of 0-2 and 9 had a mRS score of 3-6 at discharge. H/H grade was closely related to the clinical outcomes, whereas the presence of IPH was not. Overall immediate angiographic outcomes were complete occlusion in 15, residual neck in 11, and residual aneurysm in 5. The overall recurrence rate was 35.3%. Complications including posttreatment rebleeding occurred in 5 patients. Symptomatic vasospasm occurred in 1 of the 18 patients with H/H grades 1-3. Endovascular therapy of ruptured DACA aneurysms is feasible and effective. However, the risks of recurrence and posttreatment bleeding remain to be resolved.

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Section: Discussionmentioning

confidence: 99%

Feasibility and Efficacy of Endovascular Therapy for Ruptured Distal Anterior Cerebral Artery Aneurysms

Oishi

Nonaka

Yamamoto

et al. 2013

Neurol. Med. Chir.(Tokyo)

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“…The nature of the aneurysm was mostly saccular. Although saccular bilobed aneurysm of ACA was also reported by Jagetia et al [8] .…”

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confidence: 74%

Azygos anterior cerebral artery aneurysm with subarachnoid hemorrhage

Chowdhury¹,

Ahmed²,

Chaurasia³

et al. 2018

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“…[51112] Although the presence of unpaired ACA is common in lower mammals, it is uncommon in humans, with an incidence varying from 1% to 4%. [137818] Others important anomalies of ACA are the bihemispheric ACA, triplications ACA, and crossover branches of ACA. [1112]…”

Section: Discussionmentioning

confidence: 99%

“…[137818] In this variant of normal embryogenesis, the confluence of both A1 segments results in the formation of a single distal ACA in the interhemispheric fissure. [138] This unique vascular configuration is frequently associated with saccular aneurysms and has significant impact on the arterial hemodynamics of the frontal lobe. [7] The increased blood flow in the azygos pericallosal, which has twice the hemodynamic pressure of a normally paired A2 region, results in significant stress at the bifurcation of distal ACA and predispose to aneurysm formation.…”

Section: Introductionmentioning

confidence: 99%

Aneurysm of azygos anterior cerebral artery associated with falcine meningioma: Case Report and review of the literature

Meguins¹,

Hidalgo²,

Spotti³

et al. 2017

Surg Neurol Int

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Background:The azygos anterior cerebral artery (ACA) is an uncommon intracranial vascular anomaly of the circle of Willis. Identification of aneurysm from azygos ACA with anterior falcine meningioma is an extremely rare association. The aim of the present study is to report the case of an adult female with a ruptured aneurysm from azygos ACA in association with an anterior falcine meningioma.Case Description:A 65-year-old female was admitted in the Emergency Department reporting sudden onset of severe headache. Computed tomography (CT) revealed an intracerebral hematoma and an expansive calcified lesion. AngioCT showed the presence of a large aneurysm in the distal portion of the azygos ACA. During the surgical procedure, it was possible to visualize the aneurysm in contact with an expansive lesion arising from the anterior third of the falx. Microsurgical clipping of the aneurysm was performed uneventfully and partial resection of the tumor was done. Histopathological analysis showed a fibrous meningioma. The patient was discharged home on the seventh postoperative day in good clinical conditions.Conclusion:The association of aneurysm from azygos ACA and falcine meningioma is an extremely rare event and must be remembered when expansive masses are present in the vicinity of vascular lesions.

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Saccular bilobed aneurysm of an azygos anterior cerebral artery

Cited by 14 publications

References 8 publications

Feasibility and Efficacy of Endovascular Therapy for Ruptured Distal Anterior Cerebral Artery Aneurysms

Feasibility and Efficacy of Endovascular Therapy for Ruptured Distal Anterior Cerebral Artery Aneurysms

Azygos anterior cerebral artery aneurysm with subarachnoid hemorrhage

Aneurysm of azygos anterior cerebral artery associated with falcine meningioma: Case Report and review of the literature

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