Ruptured and unruptured aneurysms of the accessory anterior cerebral artery combined with a blood blister-like aneurysm of the anterior communicating artery

• Published in: Neurology India Vol. 57; no. 1; pp. 85 - 87
• Main Authors: Seo, Dae-Hee, Lee, Won-Cheol, Choe, Il-Seung, Park, Sung-Choon, Ha, Young-Soo
• Format: Journal Article
• Language: English
• Published: India Medknow Publications on behalf of the Neurological Society of India 01.01.2009; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd
• Subjects: Accessory anterior cerebral artery; Aneurysm, Ruptured - complications; Aneurysm, Ruptured - pathology; Aneurysms; Anterior Cerebral Artery - pathology; anterior communicating artery; blood blister-like aneurysm; Blood clots; Care and treatment; Case studies; Cerebral Arteries - pathology; CT imaging; Diagnosis; Dissection; Health aspects; Hematoma - pathology; Humans; Intracranial Aneurysm - complications; Intracranial Aneurysm - pathology; Intracranial aneurysms; Male; Medical treatment; Middle Aged; Patient outcomes; Risk factors; Subarachnoid Hemorrhage - pathology; Tomography; Tomography, X-Ray Computed; Vasospasm, Intracranial - pathology; Veins & arteries; India
• ISSN: 0028-3886; 1998-4022
• DOI: 10.4103/0028-3886.48806

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.