Korean J Cerebrovasc Surg.  2005 Dec;7(4):324-328.

Dissecting Aneurysm at the A1 Segment of the Anterior Cerebral Artery Manifesting as Subarachnoid Hemorrhage: Two Case Reports

• Kim YW
• Yoo SH
• Kim SR
• Kim SD
• Park IS
• Baik MW

Abstract

Two cases of intracranial dissecting aneurysms of the A1 segment of the anterior cerebral artery(ACA) associated with subarachnoid hemorrhage(SAH) are described. Two patients presented with a ruptured dissecting aneurysm manifesting as sudden bursting headache. Computerized tomography(CT) revealed subarachnoid hemorrhage. In the first case, cerebral angiography revealed a diffuse dilatation of left A1 segment with pooling of contrast medium and poor collateral flow through the anterior communicating artery(AcomA). The dissecting aneurysm was wrapped with a trousers shaped artificial dura, fixed with an aneurysmal clip and coated with fibrin glue. He was discharged without neurological deficit. In the second case, 3 dimensional computerized tomography(3D CT) was checked because the diagnostic angiography was not available due to poor patient's condition. 3D CT showed fusiform dilatation of right A1 segment, focal severe stenosis of proximal A1 segment of ACA, AcomA within normal shape and no laterality of A1 dominance. Trapping surgery was done successfully and she had no neurological deficit at discharge. In the case of SAH of unknown origin, dissecting aneurysm should be kept in mind and surgical treatment might be beneficial.

Keyword

Dissecting aneurysm; A1 segment; Anterior cerebral artery; Subarachnoid hemorrhage

MeSH Terms

Aneurysm
Aneurysm, Dissecting*
Angiography
Anterior Cerebral Artery*
Cerebral Angiography
Constriction, Pathologic
Dilatation
Fibrin Tissue Adhesive
Headache
Humans
Subarachnoid Hemorrhage*
Fibrin Tissue Adhesive