title: Ruptured fusiform aneurysm of the proximal anterior cerebral artery (A1 segment).
abstract: A 42-year-old man presented with a ruptured fusiform aneurysm of the proximal anterior cerebral artery (A(1) segment) manifesting as sudden onset of severe headache. Brain computed tomography revealed subarachnoid hemorrhage in the basal cisterns, and left carotid angiography demonstrated a fusiform aneurysm of the left A(1) segment. He underwent surgery via the left pterional approach. The left A(1) segment exhibited a fusiform configuration. Adequate development of the anterior communicating artery was confirmed. Trapping of the aneurysm was performed. The aneurysm was associated with atherosclerotic changes. The postoperative course was uneventful, and the patient was discharged without neurological deficits 1 month after surgery. Fusiform aneurysm of the A(1) segment is quite rare, and tends to bleed, so must be treated. The atherosclerotic origin indicates long-term follow up to identify subsequent lesions.
authors.affiliation: Department of Neurosurgery, Saku Municipal Asama General Hospital, Saku, Nagano, Japan. y-aoki@sf6.so-net.ne.jp
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Aoki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Nemoto
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Yokota
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kano
authors.forename: Shouzou
authors.initials: S
authors.lastname: Goto
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sugo
mesh_terms: D000328:Adult; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D002533:Cerebral Angiography; D002941:Circle of Willis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D004244:Dizziness / Q000209:etiology; D004621:Embolization, Therapeutic; D006261:Headache / Q000209:etiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D002537:Intracranial Arteriosclerosis / Q000150:complications / Q000503:physiopathology; D008297:Male; D019635:Neurosurgical Procedures; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome