Ruptured and unruptured aneurysms of the accessory anterior cerebral artery combined with a blood blister-like aneurysm of the anterior communicating artery.
Anterior communicating artery (Acom) complex and anterior cerebral artery (ACA) are the frequent sites of arterial anomalies. Aneurysms associated with triplicate ACA are rare. Blood blister-like aneurysm (BBA) of the Acom is also very rare. This report presents these two rare types of aneurysms in a 63-year old man who presented with subarchnoid hemorrhage secondary to accessory ACA aneurysmal rupture. During surgery, a BBA of the Acom was also found. Both the aneurysms were treated simultaneously. The BBA bled intraprocedurally but was repaired successfully by neck reconstruction and clipping with the preservation of the parent and the branching arteries. The ruptured accessory ACA aneurysm was clipped together with the artery which had multiple aneurysms distally. For the treatment of a complex aneurysm like this, accurate understanding of the anatomic variations, proper imaging study and extremely careful technique are essential.
Seo
Dae-Hee
DH
Department of Neurosurgery, Myongji Hospital, Kwandong University School of Medicine, Koyang, Korea. nsdrseo@kwandong.ac.kr
Lee
Won-Cheol
WC
Choe
Il-Seung
IS
Park
Sung-Choon
SC
Ha
Young-Soo
YS
D017542:Aneurysm, Ruptured / Q000150:complications* / Q000473:pathology*; D020771:Anterior Cerebral Artery / Q000473:pathology*; D002536:Cerebral Arteries / Q000473:pathology*; D006406:Hematoma / Q000473:pathology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000473:pathology; D014057:Tomography, X-Ray Computed; D020301:Vasospasm, Intracranial / Q000473:pathology