title: Aneurysms located at the proximal anterior cerebral artery and anterior communicating artery associated with middle cerebral artery aplasia: case report.
abstract: BACKGROUND
  Aneurysms arising from the proximal anterior cerebral artery (ACA) are quite rare. Here, we report upon such a case of aneurysms located at the proximal ACA and anterior communicating artery associated with middle cerebral artery (MCA) aplasia.
  
  
  METHODS
  A 64-year-old woman complained of severe headache. Brain computed tomography scans demonstrated acute subarachnoid hemorrhage. Angiograms showed 2 aneurysms located at the anterior communicating artery and proximal ACA, but did not show an MCA shadow on the lesion side. Instead, multiple collateral vessels ran toward the sylvian fissure and supplied the MCA territory, together with hypertrophied perforating branches. The operative findings confirmed that the cordlike rudimentary MCA had no internal blood flow. The 2 aneurysms were secured by neck clipping.
  
  
  CONCLUSIONS
  The combined effects of these anomalies on the hemodynamic equilibrium of the arteries and the genesis of the aneurysms are noteworthy.
authors.affiliation: Department of Neurosurgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul 100-032, Republic of Korea. hanibalkms@hanmail.net
authors.forename: Myoung Soo
authors.initials: MS
authors.lastname: Kim
authors.forename: Chang Wan
authors.initials: CW
authors.lastname: Oh
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Hur
authors.forename: Jong-Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Hyun Koo
authors.initials: HK
authors.lastname: Lee
mesh_terms: D020771:Anterior Cerebral Artery / Q000473:pathology; D002539:Cerebral Arterial Diseases / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology; D019635:Neurosurgical Procedures / Q000379:methods; D013345:Subarachnoid Hemorrhage / Q000209:etiology; D013525:Surgical Instruments