Neurological Surgery No Shinkei Geka Volume 21, Issue 4 (April 1993)

An Experience of Dissecting Cerebral Aneurysm of the Anterior Cerebral Artery Ryoichi ISHIKAWA 1 , Shigeo SUNAGAWA 1 , Isao ITOH 1 , Kazuhiko IWASHITA 1 1Department of Neurosurgery, St. Luke's International Hospital Keyword: Dissecting cerebral aneurysm , Anterior cerebral artery , Cerebral infarction , Antiplatelet therapy pp.355-359
Published Date 1993/4/10
  • Abstract
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Intracranial dissecting aneurysms have been reported occasionally in recent years. However, excluding dissect-ing aneurysms which extend from the proximal intracra-nial carotid artery, dissecting aneurysms arising merely in ACA are found only rarely.

We are reporting here a case of a 42 year-old gentle-man who did not present any particular causative etiolo-gy such as trauma or other basic diseases causing arte-ritis. Our patient is the 8th case, as far as we could find in the literature, in which the dissection of the arterial wall originated at the ACA. The patient was thought to have a tiny saccular aneurysm at the A 1-2 junction of the right ACA associated with vasospasm in the distal ACA on the angiogram. The patient had motor weakness on the left side and headache as well as a low density area in the territory of the ACA on the CT scan. A craniotomy was performed verifying the aneurysm to be dissecting in type without any sign of recent subarachnoid hemor-rhage in the surrounding structures. No aggressive surgic-al treatment such as trapping of the aneurysm was done because the collateral blood circulation in that territory of the distal right ACA seemed to he poor and the pa-tient no longer had neurological deficit at the time of op-eration. The patient was treated successfully with anti-platelet therapy. On the follow-up angiogram performed 3.5 months after the onset of the illness, we noted the disappearance of the abnormal angiographical findings of the dissecting aneurysm and distal arterial narrowing (pearl and string sign).

Our impression is that dissecting aneurysms arising at the ACA evolve with a less severe clinical course than that of dissecting aneurysms in the intracranial carotid artery or middle cerebral artery.

Copyright © 1993, Igaku-Shoin Ltd. All rights reserved.


Neurological Surgery 脳神経外科
21巻4号 (1993年4月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院