scholarly journals Ruptured Dissecting Aneurysm of the Anterior Cerebral Artery A1 Segment Associated with Multiple Intracranial Aneurysms

2018 ◽  
Vol 46 (1) ◽  
pp. 40-44 ◽  
Author(s):  
Michio NAKAMURA ◽  
Tadashi MIYAZAKI ◽  
Hiroshi KIKUCHI ◽  
Yoshihiko FUSE
2002 ◽  
Vol 16 (2) ◽  
pp. 158-164 ◽  
Author(s):  
K. Mori ◽  
T. Yamamoto ◽  
M. Maeda

2008 ◽  
Vol 1 ◽  
pp. CCRep.S833
Author(s):  
Akihiro Kurosu ◽  
Shizuo Hatashita ◽  
Hideo Ueno

Introduction Intracranial dissecting aneurysms have been increased due to recent advancements in diagnostic imaging. However there have been little article with subarachnoid hemorrhage and cerebral infarction occurring almost at the same time. We performed the surgical treatment and obtained good result. Case presentation A 47-year-old male presented to our hospital with chief complaints of sudden headache and mild paralysis of the left lower extremity. Brain imaging at admission revealed cerebral infarction in the right frontal lobe and subarachnoid hemorrhage in the frontal convexy and anterior interhemispheric fissure. The left and right internal carotid angiography showed a bulging cerebral aneurysm at the left A1–A2 junction and stenosis and arterial dissections in the peripheral of the bilateral anterior cerebral artery. Wrapping was performed for the dissecting aneurysm of the left anterior cerebral artery. For the right anterior cerebral artery, trapping was performed at the A2 segment without vascular anastomosis. The patient's postoperative course was uneventful. Conclusion A consensus has not been reached on the treatment for intracranial dissecting aneurysms. Proximal trapping without vascular reconstruction was performed for the right anterior cerebral artery without vascular anastomosis to prevent rebleeding. However no symptoms of neurological deficiency were observed. Proximal trapping of dissecting aneurysm seems to be a good option when patient's functional and life prognosis are taken into account in case that vascular reconstruction will be anticipated difficulty.


2019 ◽  
Vol 18 (3) ◽  
pp. E76-E77
Author(s):  
Benjamin K Hendricks ◽  
Robert F Spetzler

Abstract Dissecting aneurysms can pose an immense surgical challenge, and intervention often involves high risk for rerupture because of the volatile nature of the fibrin thrombus overlying the rupture site. This patient presented following rupture of a dissecting aneurysm along the A2 segment of the anterior cerebral artery (ACA). The patient underwent a right orbitozygomatic craniotomy, and the aneurysm was approached within the interhemispheric fissure. Manipulation of the aneurysm dome resulted in intraoperative rerupture of the aneurysm, which was controlled by the application of a temporary clip on the parent A2 proximally and distally. Aneurysmectomy of the thin diseased vessel wall was performed. The defect was filled by transecting the frontopolar branch of the ACA and sewing the frontopolar branch onto the aneurysmectomy defect. This provided a suitable patch for the ACA defect. Postprocedural indocyanine green angiography demonstrated patency of the A2 and the anastomosed frontopolar branch. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.


2017 ◽  
Vol 7 (1-2) ◽  
pp. 48-52
Author(s):  
Varun Naragum ◽  
Mohamad AbdalKader ◽  
Thanh N. Nguyen ◽  
Alexander Norbash

The anterior communicating artery is a common location for intracranial aneurysms. Compared to surgical clipping, endovascular coiling has been shown to improve outcomes for patients with ruptured aneurysms and we have seen a paradigm shift favoring this technique for treating aneurysms. Access to the anterior cerebral artery can be challenging, especially in patients with tortuous anatomy or subarachnoid hemorrhage or in patients presenting with vasospasm. We present a technique for cannulating the anterior cerebral artery using a balloon inflated in the proximal middle cerebral artery as a rebound surface.


1993 ◽  
Vol 4 (3) ◽  
pp. 267-271
Author(s):  
Kazuo Nakakita ◽  
Tetsuya Kuniyasu ◽  
Shigeru Tanaka ◽  
Chiiho Fujii ◽  
Akitsugu Kohama

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