title: Saccular bilobed aneurysm of an azygos anterior cerebral artery.
abstract: An azygos anterior cerebral artery is an anatomical variant in which the anterior communicating artery is absent and both the A1 segments unite to form a single A2 segment of the artery. This anatomical variant may be associated with holoprosencephaly and may predispose to aneurysm formation, however the association of such an anomaly with an aneurysm is rare. When associated with an aneurysm, it poses management difficulties due to the single distal anterior cerebral artery. Most of the reported aneurysms with such an anomaly are saccular and located in the distal part of the artery. We report a patient with a wide neck saccular multilobed aneurysm who presented after a grade 3 subarachnoid haemorrhage. A right pterional craniotomy and clipping of the aneurysm was performed following cerebral angiography. The mechanism of formation and difficulties in management of such an aneurysm is discussed.
authors.affiliation: G.B. Pant Hospital and Maulana Azad Medical College, Department of Neurosurgery, 1-JL Nehru Marg, New Delhi 110002, India. anita_jagetia@yahoo.com
authors.forename: Anita
authors.initials: A
authors.lastname: Jagetia
authors.forename: Pratap N
authors.initials: PN
authors.lastname: Kumar
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Sinha
authors.forename: Ajay
authors.initials: A
authors.lastname: Sharma
mesh_terms: D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002533:Cerebral Angiography / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods