title: Distal calcarine fusiform aneurysm: a case report and review of literature.
abstract: A 50 year old female who was operated for atrial septal defect 8 years back, presented with clinical features suggestive of subarachnoid haemorrhage (grade I, Hunt and Hess). CT scan of brain revealed haemorrhage in all the supratentorial basal cisterns, sylvian cistern and small haematoma in the left occipital lobe. Conventional CT and MR angiography revealed aneurysm in relation to distal part of the calcarine branch of the left posterior cerebral artery (PCA). Left occipital craniotomy in prone position followed by deep dissection in the occipital lobe showed fusiform aneurysm of the distal part of the calcarine branch. PCA aneurysms constitute only 0.2 to 1% of all intracranial aneurysms and among them distal PCA aneurysms are most rare, constituting only 1.3%. They too are mostly seen at the bifurcation of the PCA. The present case however, is unique in the sense that it has developed as a fusiform aneurysm in the distal part of the calcarine branch. To the best of our knowledge this is rare among the rarest.
authors.affiliation: Departments of Neurosurgery, Pathology, Imageology and Anaesthesiology, Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad, 500082, India.
authors.forename: T V
authors.initials: TV
authors.lastname: Ramakrishnamurthy
authors.forename: A K
authors.initials: AK
authors.lastname: Purohit
authors.forename: C
authors.initials: C
authors.lastname: Sundaram
authors.lastname: Ramamurti
authors.forename: Y
authors.initials: Y
authors.lastname: Rajender
mesh_terms: D003399:Craniotomy; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D020769:Posterior Cerebral Artery / Q000473:pathology*; D013345:Subarachnoid Hemorrhage / Q000473:pathology / Q000601:surgery; D014793:Visual Cortex / Q000098:blood supply* / Q000473:pathology*