Saccular Aneurysm of the Accessory Middle Cerebral Artery. Case Report.

Fujiwara, Kazunori; Saito, Keiichi; Ebina, T

doi:10.2176/nmc.43.31

Cited by 18 publications

(19 citation statements)

References 11 publications

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“…To prevent ischemic complications of the accessory MCA territory, the proximal portion of the ACA should be first identified and careful dissection is necessary at the junction of the A 1 and accessory MCA during surgical intervention. 2,9) If the aneurysm adheres on the frontal base as in our case, minimum retraction of the frontal lobe is necessary. 2) Three-dimensional digital subtraction angiography was very useful for this complicated aneurysm.…”

Section: Discussionmentioning

confidence: 89%

“…2,9) If the aneurysm adheres on the frontal base as in our case, minimum retraction of the frontal lobe is necessary. 2) Three-dimensional digital subtraction angiography was very useful for this complicated aneurysm. Standard digital subtraction angiography could not show the origin of the accessory MCA and the small perforators around the aneurysm in our case.…”

Section: Discussionmentioning

confidence: 89%

“…[2][3][4][5][6]9,11,13,14,17) The prognosis was good except in a patient who developed spasm (Case 1) and a patient with intracranial hemorrhage (Case 8). Accessory MCA is more slender than the A 1 segment and has a complicated course.…”

Section: Discussionmentioning

confidence: 99%

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Ruptured Anterior Cerebral Artery Aneurysm at the Origin of the Accessory Middle Cerebral Artery -Case Report-

Wakabayashi

Hori

Kondoh

et al. 2011

Neurol. Med. Chir.(Tokyo)

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A 36-year-old female patient was admitted to our hospital with a rare case of aneurysm at the origin of the accessory middle cerebral artery (MCA) manifesting as severe headache and vomiting. Neurological examination did not detect any abnormalities or consciousness disturbance. Computed tomography demonstrated diffuse subarachnoid hemorrhage. Magnetic resonance angiography showed an aneurysm in the horizontal portion of the left anterior cerebral artery (A 1 ). Digital subtraction angiography and three-dimensional digital subtraction angiography demonstrated a saccular aneurysm originating at the junction of the left A 1 and accessory MCA. Another accessory MCA originated at the proximal portion of the left A 2 without an aneurysm. Two accessory MCAs were found on the left. Neck clipping was performed via a left pterional approach. One month after admission, she was discharged without neurological deficits.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 89%

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Ruptured Anterior Cerebral Artery Aneurysm at the Origin of the Accessory Middle Cerebral Artery -Case Report-

Wakabayashi

Hori

Kondoh

et al. 2011

Neurol. Med. Chir.(Tokyo)

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“…The direction of blood flow in the accessory MCA is recurrent to that in the parent vessel, and such recurrent blood flow is likely to cause high levels of hemodynamic stress at the arterial junction, leading to vessel tortuosity and aneurysm growth 3,9,17) . The first case of an aneurysm of an accessory MCA was first reported in 1977.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, cerebral aneurysms occurring in association with this anomalous artery are very rare. To our knowledge (based on PubMed search), there have only been ten previous reports of accessory MCA-related aneurysms, including nine saccular aneurysms originating from the junction of the accessory MCA [3][4][5]7,8,12,13,16,18,21) . In the present study, we report two additional cases of ruptured saccular aneurysms at the anterior communicating artery (ACoA) complex in close association with accessory MCA.…”

Section: Introductionmentioning

confidence: 99%

Saccular Aneurysm at the Anterior Communicating Artery Complex Associated with an Accessory Middle Cerebral Artery : Report of Two Cases and Review of the Literature

Kang

Park

et al. 2009

J Korean Neurosurg Soc

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J Korean Neurosurg Soc 46 : [568][569][570][571] 2009 Accessory middle cerebral artery (MCA) is an infrequent vascular anomaly of the brain. Cerebral aneurysms associated with this anomalous artery are also very rare. To our knowledge, there have only been ten previous reports of an aneurysm associated with accessory MCA. The authors present two patients with accessory MCA-related aneurysms. A 38-year-old male and a 59-year-old female both presented with suddenonset severe headache. In both patients, computed tomography (CT) scan revealed subarachnoid hemorrhage. A subsequent angiogram demonstrated an accessory MCA arising from the anterior cerebral artery (ACA) and a saccular aneurysm at the anterior communicating artery (ACoA) complex associated with an accessory MCA. Surgical clipping allowed for complete exclusion of the aneurysm from the arterial circulation. Based on our review of the ten cases of aneurysms associated with accessory MCA documented in the literature, we suggest that accessory MCA-related aneurysms can be classified according to whether the accessory MCA originates from the proximal A1 segment or from the ACoA complex. We also emphasize the importance of precise interpretation of preoperative angiograms and intraoperative precaution in determining the presence of this anomalous artery prior to temporary clip placement.

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Endovascular treatment for aneurysms at the A1 segment of the anterior cerebral artery: current difficulties and solutions

Hou

Guo

et al. 2020

Acta Neurol Belg

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Aneurysms located at the A1 segment of the anterior cerebral artery are considered rare and unique entities. Endovascular treatment (EVT) is effective in preventing aneurysmal bleeding. However, EVT for A1 aneurysms is difficult due to their distinctive configurations. A current review of EVT for A1 aneurysms is lacking. Therefore, we focused on the available literature on this specific issue. To more clearly expound this entity, we also provided some illustrative cases. The A1 segment can be equally divided into the proximal, middle, and distal segments. Proximal aneurysms are most common and difficult to treat via EVT. The A1 segment has a complex anatomy and many important branches. Due to the small size, predominant posterior direction, and sharp upturn of the microcatheter from the parent artery, microcatheter positioning and support is difficult for A1 aneurysms. EVT for A1 aneurysms mainly includes reconstructive and deconstructive strategies. The complications of EVT for A1 aneurysms include aneurysmal perforation, thromboembolic events, and coil protrusion related to stent-assisted embolization. A1 aneurysms represent rare and difficult vascular lesions. EVT is quite challenging for A1 aneurysms due to their distinctive configurations. The outcomes are acceptable.

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Saccular Aneurysm of the Accessory Middle Cerebral Artery. Case Report.

Cited by 18 publications

References 11 publications

Ruptured Anterior Cerebral Artery Aneurysm at the Origin of the Accessory Middle Cerebral Artery -Case Report-

Ruptured Anterior Cerebral Artery Aneurysm at the Origin of the Accessory Middle Cerebral Artery -Case Report-

Saccular Aneurysm at the Anterior Communicating Artery Complex Associated with an Accessory Middle Cerebral Artery : Report of Two Cases and Review of the Literature

Endovascular treatment for aneurysms at the A1 segment of the anterior cerebral artery: current difficulties and solutions

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