Proximity of the distal anterior cerebral artery (dACA) and the edge of the falx has been hypothetically implicated in the pathogenesis of traumatic dACA aneurysms. A 57-year-old patient presented with posttraumatic intracranial hemorrhage and an A3-bifurcation aneurysm that increased in size over the following 2 weeks. Because of higher endovascular risk, surgical clipping was preferred. Surgery revealed a fibrous adhesion between the falx and the dACA at the aneurysm site. This adhesion could provide an anatomical reason for the formation of a traumatic dACA aneurysm at the edge of the falx or rupture of a preexisting aneurysm.
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