ANEURYSMS OF THE DISTAL ANTERIOR CEREBRAL ARTERY Kazuo Kinoshita 1,2 , Yasuhiko Matsukado 1,2 1Department of Neurosurgery, Kumamoto University Hospital pp.1193-1202
Published Date 1975/11/1
DOI https://doi.org/10.11477/mf.1406203803
  • Abstract
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Aneurysms of the distal anterior cerebral arteryare relatively uncommon and consist of about 4%of the intracranial aneurysms.

In this paper 11 aneurysms of the distal anteriorcerebral arteries in 10 patients, 6.7% of the intra-cranial aneurysms experienced in our Departmentin past 5 years, were reported. 10 of them weresaccular and one was fusiform. All of them arosefrom the pericallosal artery at the genu of thecorpus callosum.

The patients with these aneurysms had higherincidence of coexisting anomalies of the anterior cerebral artery than the ordinary stastical incidencesreported from the angiographies and autopsies.

The azygos anterior cerebral artery was seen in2 cases, the supreme anterior communicating artery(Laitinen) with a saccular aneurysm on it in onecase, the defective horizontal portion of the anteriorcerebral artery on one side in 2 cases, the hypo-plastic pericallosal artery on both sides in one case,and two aneurysms of one irregular and hypoplasticpericallosal artery in one case. Two cases had otheraneurysms in the middle cerebral artery respectively.Only 3 cases showed normal features of the bilateralanterior cerebral artery.

These anomalies with the saccular aneurysmssuggested that the developemental defect inthis artery might play an important role in theformation of this aneurysm.

In analyzing clinical course of these patientscharacteristic clinical symptoms and signs suggest-ing the rupture of this aneurysm were not present.

Clipping or ligation of the aneurysm was per-formed in 7 cases and removal of the aneurysmalsac in one case with the fusiform aneurysm. Ananeurysm of the supreme anterior communicatingartery disappeared spontaneously. One patient re-fused operation. Thus 8 cases were operated with-out operative mortality.

At operation a unilateral or bilateral frontal ex-posure may be employed although a unilateralfrontal flap is adequate in the majority of casesand the aneurysm is easily found when it is ap-proached through interhemispheric fissure.

Copyright © 1975, Igaku-Shoin Ltd. All rights reserved.


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