Aneurysms located at the proximal anterior cerebral artery and anterior communicating artery associated with middle cerebral artery aplasia: case report.
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.
Kim
Myoung Soo
MS
Department of Neurosurgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul 100-032, Republic of Korea. hanibalkms@hanmail.net
Oh
Chang Wan
CW
Hur
Jin Woo
JW
Lee
Jong-Won
JW
Lee
Hyun Koo
HK
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