title: Bilateral A1 fenestrations: Report of two cases and literature review.
abstract: BACKGROUND
  Bilateral fenestration of the A1 segment of anterior cerebral artery (ACA) is an uncommon anomaly. Our objective is to describe two cases with this anomaly and to review the literature.
  
  
  METHODS
  A 50-year-old woman presented with subarachnoid hemorrhage from a ruptured A1 aneurysm. Angiography revealed bilateral A1 segment fenestration as well as an aneurysm on the proximal end of fenestration on the right side. The second case is that of an 86-year-old woman who was found to have bilateral fenestration of A1 segment at autopsy.
  
  
  CONCLUSIONS
  Bilateral A1 fenestration is an uncommon anomaly that may be associated with an aneurysm. In surgical clipping of such cases, extreme caution should be exercised to inspect both arms of the fenestration since both may have multiple perforators as demonstrated in our autopsy specimen. This will be the first published pictorial demonstration of these perforators arising from the arms of fenestration.
authors.affiliation: Department of Neurological Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
authors.forename: Erinç
authors.initials: E
authors.lastname: Aktüre
authors.forename: Anıl
authors.initials: A
authors.lastname: Arat
authors.forename: David B
authors.initials: DB
authors.lastname: Niemann
authors.forename: M Salamat
authors.initials: MS
authors.lastname: Salamat
authors.forename: Mustafa K
authors.initials: MK
authors.lastname: Başkaya