Published Date 1968/2/1
DOI https://doi.org/10.11477/mf.1406202341
  • Abstract
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Aneurysms of the peripheral anterior cerebral artery are relatively uncommon and range from 2.5 to 5.5% of incidence in statistics reported by many authors. In this paper 6 cases of the peripheral anterior cerebral aneurysm are reported and their clinical data, radiological findings and operations are discribed.

Incidences of anomalies of the anterior cerebral artery coexisting with aneurysm are significantly higher than the statistical incidences reported from ordinary autopsies and this fact suggests these de-velopmental anomalies of the artery might play crucially important roles in the development of this aneurysm.

Rupture of this aneurysm develops rather charac-teristic symptoms by extravasation of blood and in-duction of arterial spasm, earring out what is in fact a more or less posteriorly placed leucotomy or cin-gulectomy with all the untoward effects of it as im-parment of consciousness, psychic symptoms, motor and sensory disturbances dominant on the lower limb and disturbance of micturition. It is also emphasized that especially the left peripheral anterior cerebral aneurysm shows more serious than the right.

One case which failed to recover to an operable stage died of her third haemmorrhage. Other five cases were operated on by approaching along the medial aspect of the frontal lobe and wrapping, clipping or ligating aneurysm. There was no oper-ative or remote mortality. When an aneurysm itself horizontally bilobular on its antero-posterior view of angiography, special precaution should be always kept in mind in its dissecting process because of possible nesting of its partial aneurysmal lobule in the adjacent brain substance and also not to injure its parent artery during operation.

During convalescent period 3 cases showed mild temporary psychic symptoms, showing euphoria, illusion, akinetic mutism and catatonia ; 2 of 3 show-ed temporary urinal incontinence and 1 showed per-sisting hemiplegia. All these 3 cases had aneurysm of the left anterior cerebral artery treated with silver clipping and this fact might emphasize the speciality and subtlety of the left anterior cerebral aneurysm in the clinical and therapeutic points of view.

Copyright © 1968, Igaku-Shoin Ltd. All rights reserved.


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