[A case of A3-A3 bypass and proximal clipping for a ruptured left A1 dissecting aneurysm].
A 58-year-old woman was admitted to our hospital with sudden onset of headache. CT and angiogram revealed subarachnoid hemorrhage due to a dissecting aneurysm at the left A1 segment. ACoA was not identified. We performed proximal clipping with A3-A3 bypass for preventing the recurrence of the hemorrhage and for reducing ischemia in the territory of the left ACA. After the operation, CT revealed the infarctions in the corpus callosum, the left medial frontal lobe and the genu of the internal capsule. But the postoperative angiogram demonstrated no aneurysm and the opacification of the recurrent artery of Heubner and the part of perforating branches. A3-A3 bypass was patent. The patient experienced a good recovery without recurrence of bleeding.
Shibata
Sumiya
S
Department of Neurosurgery, Kobe City Medical Center General Hospital, 4-6 Minatojimanakamachi, Chuo-ku, Kobe-city, Hyogo 650-0046, Japan.
Ueno
Yasushi
Y
Adachi
Hidemitsu
H
Kunieda
Takeharu
T
Imamura
Hirotoshi
H
Koyanagi
Masaomi
M
Sakai
Nobuyuki
N
Kikuchi
Haruhiko
H
D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D017542:Aneurysm, Ruptured / Q000601:surgery*; D020771:Anterior Cerebral Artery; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000209:etiology; D003337:Corpus Callosum / Q000098:blood supply; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply; D006801:Humans; D020772:Internal Capsule / Q000098:blood supply; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D013345:Subarachnoid Hemorrhage / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014654:Vascular Patency