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Case Reports
. 2007 Oct;42(4):342-5.
doi: 10.3340/jkns.2007.42.4.342. Epub 2007 Oct 20.

Saccular aneurysm of the azygos anterior cerebral artery: three case reports

Jun Suk Huh  1 , Sang Keun Park, Jun Jae Shin, Tae Hong Kim
Affiliations
Case Reports

Saccular aneurysm of the azygos anterior cerebral artery: three case reports

Jun Suk Huh et al. J Korean Neurosurg Soc. 2007 Oct.

Abstract

The azygos anterior cerebral artery, a rare anomaly in the circle of Willis in which only a single vessel supplies the medial aspects of both anterior cerebral hemispheres, is closely associated with saccular aneurysms. We present three cases of azygos anterior cerebral artery aneurysms among the 781 cerebral aneurysms surgically treated at our institution in an 11-year period. These three cases all involved elderly women who presented with subarachnoid hemorrhage. Conventional cerebral angiography and CT angiography revealed small saccular aneurysms at the distal ends of the azygos anterior cerebral arteries. These aneurysms were clipped successfully using a bifrontal interhemispheric approach. Hence, the pathogenesis of these particular aneurysms relating to hemodynamic change, associated anomalies, and surgical pitfalls is discussed with review of literature.

Keywords: Anomaly; Azygos anterior cerebral artery; Saccular aneurysm.

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Figures

Fig. 1
Fig. 1
A : The initial Brain computed tomography (CT) shows subarachnoid hemorrhage within the basal cistern and sylvian fissure with hematoma within interhemispheric fissure. B : The unilateral carotid angiography with contralateral carotid compression shows the unpaired distal anterior cerebral artery(arrow head) and saccular aneurysmal dilatation on the A2 & A3 junction (arrow). Other vascular anomalies are not seen on the angiogram.
Fig. 2
Fig. 2
A : The initial brain computed tomography (CT) shows subarachnoid hemorrhage within the basal cistern and interhemispheric fissure. There is no evidence of hydrocephalus. B : The CT angiogram shows an unpaired distal segment of the anterior cerebral artery(arrow head) and aneurysmal dilation (arrow) on its origin site.
Fig. 3
Fig. 3
A, B : The initial brain computed tomography (CT) shows subarachnoid hemorrhage within the basal cistern and interhemispheric fissure with intraventricular hemorrhage. C, D : The CT angiogram and carotid angiogram shows an unpaired distal segment of the anterior cerebral artery (arrow head) and aneurysmal dilation (arrow) on its origin site.
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