Ruptured aneurysm of the distal anterior cerebral artery: clinical features and surgical strategies
Department of Neurosurgery, Fukuoka University, Faculty of Medicine, Japan.Neurologia medico-chirurgica (Impact Factor: 0.72). 05/2007; 47(4):159-63; discussion 163-4. DOI: 10.2176/nmc.47.159
Ruptured aneurysms of the distal anterior cerebral artery (ACA) are relatively rare and surgical management provides some unique technical challenges. This retrospective analysis of 20 patients with distal ACA aneurysms evaluated the clinical features and surgical strategies. The characteristic findings were small and common concurrent aneurysms, and frequent intracerebral hematoma (ICH). Aneurysms were divided by location on the genu (n = 13), infracallosal (n = 5), and supracallosal portions (n = 2). All patients except one underwent surgery via an interhemispheric route. Unilateral craniotomy was performed for aneurysms on the genu portions without massive ICH. Bilateral craniotomies were selected for aneurysm located on the infracallosal portion or combined with massive ICH. No intraoperative rupture was observed. Favorable outcomes were achieved in 15 of 20 patients, and only one patient died. The preoperative Hunt and Kosnik grade was closely correlated with the outcome.
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- "Only a few case reports are available in the literature describing fusiform A2 aneurysm. "
ABSTRACT: Background: A2 aneurysms are rare with a reported incidence of <1% of the intracranial aneurysms. These aneurysms are located between the anterior communicating artery and genu of the corpus callosum. Fusiform aneurysms in this location are even rarer and we present one such case of fusiform A2 aneurysm treated with endovascular technique. Case Description: In this report, we present a case of ruptured fusiform A2 or proximal pericallosal artery aneurysm in a middle-aged female who presented with subarachnoid hemorrhage. She subsequently underwent endovascular parent artery occlusion, and post-procedure angiogram showed good pial collaterals filling the distal territory. She developed transient lower limb weakness which improved over the next 24 h with supportive inotrope management to maintain adequate cerebral flow. Conclusion: We report a rare unique case of ruptured fusiform proximal pericallosal artery aneurysm. Endovascular treatment of this type of aneurysm is a feasible method and can be considered as an effective alternative to surgical technique.Surgical Neurology International 07/2014; 5(Suppl 4):S199-202. DOI:10.4103/2152-7806.137752 · 1.18 Impact Factor
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ABSTRACT: The clinical, angiographic and surgical features of 13 (out of 18) patients harboring pericallosal aneurysms and operated on by the same group of neurosurgeons, are analyzed. The mortality rate of the whole series was 5.5% with good (GOS II) or excellent (GOS I) recovery in the 91.7% of cases. According to the experience of the authors pericallosal aneurysms should not be considered to have a worse prognosis than aneurysms in other locations of the anterior circulation.Neurocirugia (Asturias, Spain) 09/2005; 16(4):333-44. · 0.29 Impact Factor
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ABSTRACT: Distal anterior cerebral artery (DACA) aneurysms, also known as pericallosal artery aneurysms, represent about 6% of all intracranial aneurysms. They are located on the A2-A5 segments of the anterior cerebral artery and on its distal branches. This paper summarizes present knowledge on radiological features, treatment options, treatment results, and long-term follow-up of DACA aneurysms. Typical features of DACA aneurysms are small size, broad base, and branches originating from the base. When ruptured, they cause intracerebral hematoma in nearly half of the cases. DACA aneurysms are nowadays more often treated with microsurgical clipping than endovascular coiling due to their distal location and morphologic features. With clipping the results are same or slightly better than for aneurysms at other locations, coiling is often associated with more complications than in other aneurysms. Clipping is a long-lasting treatment with very small recurrence rate, there is no long-term data available on efficacy of coiling yet. For ruptured DACA aneurysms the most important factors affecting outcome is the severity of initial bleeding and patient's age.Acta neurochirurgica. Supplement 01/2010; 107(107):15-26. DOI:10.1007/978-3-211-99373-6_3
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