Anterior communicating artery aneurysm associated with an infraoptic course of anterior cerebral artery and rare variant of the persistent trigeminal artery: a case report and literature review.
Infraoptic course of the precommunicating segment of the anterior cerebral artery (A1) is a rare anomaly. Furthermore, the presence of this anomaly associated with persistent trigeminal artery variant has been reported in the literature only once. We present a patient who had infraoptic course of A1 associated with an ipsilateral persistent trigeminal artery variant arising from the right internal carotid artery with no apparent connection to the basilar artery. The persistent trigeminal artery variant supplied to the right posteroinferior cerebellar artery territory. The patient also had hypoplastic left vertebral artery, superior cerebellar arteries originating from posterior cerebellar arteries bilaterally, and a bilobed aneurysm of the anterior communicating artery. The aneurysm was clipped and the infraoptic course was verified during the surgery. The post-operative course was uneventful and a follow-up arteriogram on the 7th postoperative day revealed successful obliteration of the aneurysm. We reviewed the literature with respect to presentation, associated vascular anomalies, imaging, associated cerebral aneurysms and other cerebral abnormalities, and treatment of the associated aneurysms. A discussion of the embryogenesis of this rare anomaly is also provided.
Department of Neurological Surgery, University of Wisconsin, School of Medicine CSC K4/822, 600 Highland Avenue, Madison, WI 53792, USA.
Erhan
E
Turkoglu
Anıl
A
Arat
Nirav
N
Patel
Hayri
H
Kertmen
Mustafa K
MK
Başkaya
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020771:Anterior Cerebral Artery / Q000002:abnormalities* / Q000473:pathology* / Q000601:surgery; D002531:Cerebellum / Q000098:blood supply; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000473:pathology; D002648:Child; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D019635:Neurosurgical Procedures; D013525:Surgical Instruments; D014276:Trigeminal Nerve / Q000098:blood supply* / Q000473:pathology; D014715:Vertebrobasilar Insufficiency / Q000473:pathology; D055815:Young Adult