Neurological Surgery No Shinkei Geka Volume 29, Issue 8 (August 2001)

Dissecting Aneurysm of the Anterior Cerebral Artery with Later Development of Collateral Circulation : A Case Report Kinya NAKANISHI 1 , Takuya UCHIYAMA 1 , Fumiharu AKAI 1 , Yasufumi YAMADA 1 , Haruki YUGAMI 1 , Kiyoshi TUJI 1 , Mamoru TANEDA 1 1Department of Neurosurgery, Kinki University School of Medicine Keyword: dissecting aneurysm , anterior cerebral artery , collateral circulation pp.781-785
Published Date 2001/8/10
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Intracranial dissecting aneurysm (DA) is much less frequent than berry aneurysm. Such dissection in-volves mostly the vertebral and basilar arteries, followed by the internal carotid and middle cerebral arter-ies. DA of the anterior cerebral artery (ACA) is relatively rare and little is known about its natural De-velopment. Only 23 cases have been reported previously. Our present patient, a 44-year-old man, suddenlydeveloped paresis of the left leg while bathing. Diffusion magnetic resonance imaging indicated an area ofhigh signal intensity in the territory of the ACA. Angiography on clay 3 following onset showed a DA in-volving the left A2 segment. Antiplatelet therapy was administered. Further luminal narrowing in the le-sion was demonstrated by repeat angiography on day 17. Occlusion of the distal A2 segment was demons-trated together with sufficient collateral supply on clay 41. Symptoms resolved completely. DA of the ACA usually presents with ischemic attacks. Its etiology remains uncertain, and its naturalcourse is unclear. Surgical intervention is recommended for patients with intracranial hemorrhage, whilenon surgical therapies have achieved good outcomes in ischemic cases.

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Neurological Surgery 脳神経外科
29巻8号 (2001年8月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院