title: Ruptured anterior communicating artery aneurysm associated with anterior cranial fossa dural arteriovenous fistula--case report.
abstract: A 77-year-old man presented with an extremely rare association of anterior cranial fossa dural arteriovenous fistula (AVF) with anterior communicating artery (ACoA) aneurysm manifesting as consciousness deterioration due to intracerebral hemorrhage in the left frontal lobe and diffuse subarachnoid hemorrhage. Angiography confirmed the association of a dural AVF fed by both ethmoidal arteries and an ACoA aneurysm. Surgery for these two lesions was performed concurrently, and the ACoA aneurysm was found to be responsible for the hemorrhage. This association seems incidental, but is clinically significant since the preoperative determination of the bleeding point is difficult. We conclude that these two lesions should be treated simultaneously, to avoid leaving the ruptured point untreated.
authors.affiliation: Department of Neurological Surgery, National Hospital Organization Okayama Medical Center, Okayama, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Sato
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Shimizu
authors.forename: Toru
authors.initials: T
authors.lastname: Fukuhara
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Namba
mesh_terms: D000368:Aged; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging* / Q000601:surgery; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000601:surgery; D003131:Combined Modality Therapy; D035262:Cranial Fossa, Anterior / Q000098:blood supply*; D003399:Craniotomy / Q000379:methods; D003937:Diagnosis, Differential; D004292:Dominance, Cerebral / Q000502:physiology; D006261:Headache / Q000209:etiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging* / Q000601:surgery; D013525:Surgical Instruments; D014057:Tomography, X-Ray Computed; D014474:Unconsciousness / Q000209:etiology