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Case Reports
. 2022 Sep;164(9):2441-2445.
doi: 10.1007/s00701-022-05329-0. Epub 2022 Jul 30.

Traumatic pseudoaneurysm resulting from avulsion of the falcine branch of an azygos anterior cerebral artery: a case report

Sho Tsunoda  1 , Tomohiro Inoue  2 , Hiroshi Matsufuji  2 , Masafumi Segawa  2 , Atsuya Akabane  2
Affiliations
Case Reports

Traumatic pseudoaneurysm resulting from avulsion of the falcine branch of an azygos anterior cerebral artery: a case report

Sho Tsunoda et al. Acta Neurochir (Wien). 2022 Sep.

Abstract

Traumatic anterior cerebral artery (ACA) aneurysms are extremely rare. Traumatic anterior ACA aneurysms are thought to develop when the ACA at the pericallosal segment travel adjacent to immobile falx cerebri. As the majority of aneurysms are pseudoaneurysms, direct neck clipping is usually not possible, and it is often necessary to carry out direct or endovascular trapping in conjunction with proficient bypass techniques. The authors describe the first reported case of a traumatic ACA pseudoaneurysm resulting from avulsion of the falcine branch of an azygos ACA. In this case, the lacerated aneurysm wall was successfully sutured, without the need for a bypass. Neurosurgeons should be aware that avulsion of the falcine branch arising from the ACA can occur, and that this may cause a traumatic aneurysm on the distal ACA. Furthermore, direct suturing of a lacerated arterial wall should be considered a treatment option for this type of traumatic intracranial aneurysm.

Keywords: Anterior cerebral artery; Azygos; Direct suturing; Pseudoaneurysm; Traumatic aneurysm; Vessel avulsion.

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