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Accessory middle cerebral artery associated with an unruptured aneurysm at its origin.

Nomura M, Tamase A, Kamide T, Mori K, Seki S, Iida Y - Surg Neurol Int (2015)

Bottom Line: An aneurysm originating from the junction of the A1 segment of the anterior cerebral artery and accessory middle cerebral artery (Acc-MCA) is markedly rare.Due to its location and projectile direction, the neck of the aneurysm was left partially unclipped.Although an Acc-MCA aneurysm is very rare, it has a potential risk of rupture.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, 132 Katsura-cho, Sakae-ku, Yokohama 247-8581, Japan.

ABSTRACT

Background: An aneurysm originating from the junction of the A1 segment of the anterior cerebral artery and accessory middle cerebral artery (Acc-MCA) is markedly rare. We report a rare case of an Acc-MCA aneurysm, and discuss the clinical course and management of this rare condition.

Case description: A 64-year-old man with a past history of cerebral infarction was revealed to have a left Acc-MCA and an aneurysm at its origin. The aneurysm was clipped via a transsylvian approach. Due to its location and projectile direction, the neck of the aneurysm was left partially unclipped.

Conclusion: Although an Acc-MCA aneurysm is very rare, it has a potential risk of rupture. Therefore, radical treatment is necessary for such aneurysms.

No MeSH data available.


Related in: MedlinePlus

(a) Three-dimensional computed tomography angiography showing an aneurysm (arrow) at the origin of an accessory middle cerebral artery (arrowheads). (b) Angiography demonstrating an aneurysm (arrow) at the junction of A1 of the anterior cerebral artery and accessory middle cerebral artery. The accessory middle cerebral artery (arrowheads) runs laterally along with the middle cerebral artery. (c) An intra-operative photograph showing an aneurysm (arrow) at the origin of the accessory middle cerebral artery (arrowheads). The aneurysm is projecting medially. (d) An intra-operative photograph showing that the aneurysm is clipped. (e) Follow-up angiography obtained 27 months after the operation, showing a small residual neck of the aneurysm
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Figure 1: (a) Three-dimensional computed tomography angiography showing an aneurysm (arrow) at the origin of an accessory middle cerebral artery (arrowheads). (b) Angiography demonstrating an aneurysm (arrow) at the junction of A1 of the anterior cerebral artery and accessory middle cerebral artery. The accessory middle cerebral artery (arrowheads) runs laterally along with the middle cerebral artery. (c) An intra-operative photograph showing an aneurysm (arrow) at the origin of the accessory middle cerebral artery (arrowheads). The aneurysm is projecting medially. (d) An intra-operative photograph showing that the aneurysm is clipped. (e) Follow-up angiography obtained 27 months after the operation, showing a small residual neck of the aneurysm

Mentions: A 64-year-old man with a past history of diabetes mellitus, hypertension, and cerebral infarction experienced dysarthria. Diffusion-weighted magnetic resonance imaging showed a small fresh cerebral infarction in the left corona radiata. Three-dimensional computed tomography angiography [Figure 1a] and angiography [Figure 1b] demonstrated an anomalous artery originating from the left A1 of the ACA. It ran parallel to the main trunk of the left MCA to the lateral side. An aneurysm at the origin of the anomalous artery was also detected. The anomalous artery was revealed to be an Acc-MCA, and it was accompanied by an aneurysm at its origin. Seven months after the episode of cerebral infarction, the aneurysm was clipped via a left transsylvian approach. The aneurysm was found to project supramedially to the ACA [Figure 1c]; therefore, the neck was relatively difficult to observe and remained partially unclipped [Figure 1d]. His postoperative course was uneventful. He was discharged without deficit on the 17th postoperative day. Follow-up angiography [Figure 1e] performed 27 months after the operation showed no recurrence or enlargement of the aneurysm.


Accessory middle cerebral artery associated with an unruptured aneurysm at its origin.

Nomura M, Tamase A, Kamide T, Mori K, Seki S, Iida Y - Surg Neurol Int (2015)

(a) Three-dimensional computed tomography angiography showing an aneurysm (arrow) at the origin of an accessory middle cerebral artery (arrowheads). (b) Angiography demonstrating an aneurysm (arrow) at the junction of A1 of the anterior cerebral artery and accessory middle cerebral artery. The accessory middle cerebral artery (arrowheads) runs laterally along with the middle cerebral artery. (c) An intra-operative photograph showing an aneurysm (arrow) at the origin of the accessory middle cerebral artery (arrowheads). The aneurysm is projecting medially. (d) An intra-operative photograph showing that the aneurysm is clipped. (e) Follow-up angiography obtained 27 months after the operation, showing a small residual neck of the aneurysm
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4597300&req=5

Figure 1: (a) Three-dimensional computed tomography angiography showing an aneurysm (arrow) at the origin of an accessory middle cerebral artery (arrowheads). (b) Angiography demonstrating an aneurysm (arrow) at the junction of A1 of the anterior cerebral artery and accessory middle cerebral artery. The accessory middle cerebral artery (arrowheads) runs laterally along with the middle cerebral artery. (c) An intra-operative photograph showing an aneurysm (arrow) at the origin of the accessory middle cerebral artery (arrowheads). The aneurysm is projecting medially. (d) An intra-operative photograph showing that the aneurysm is clipped. (e) Follow-up angiography obtained 27 months after the operation, showing a small residual neck of the aneurysm
Mentions: A 64-year-old man with a past history of diabetes mellitus, hypertension, and cerebral infarction experienced dysarthria. Diffusion-weighted magnetic resonance imaging showed a small fresh cerebral infarction in the left corona radiata. Three-dimensional computed tomography angiography [Figure 1a] and angiography [Figure 1b] demonstrated an anomalous artery originating from the left A1 of the ACA. It ran parallel to the main trunk of the left MCA to the lateral side. An aneurysm at the origin of the anomalous artery was also detected. The anomalous artery was revealed to be an Acc-MCA, and it was accompanied by an aneurysm at its origin. Seven months after the episode of cerebral infarction, the aneurysm was clipped via a left transsylvian approach. The aneurysm was found to project supramedially to the ACA [Figure 1c]; therefore, the neck was relatively difficult to observe and remained partially unclipped [Figure 1d]. His postoperative course was uneventful. He was discharged without deficit on the 17th postoperative day. Follow-up angiography [Figure 1e] performed 27 months after the operation showed no recurrence or enlargement of the aneurysm.

Bottom Line: An aneurysm originating from the junction of the A1 segment of the anterior cerebral artery and accessory middle cerebral artery (Acc-MCA) is markedly rare.Due to its location and projectile direction, the neck of the aneurysm was left partially unclipped.Although an Acc-MCA aneurysm is very rare, it has a potential risk of rupture.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, 132 Katsura-cho, Sakae-ku, Yokohama 247-8581, Japan.

ABSTRACT

Background: An aneurysm originating from the junction of the A1 segment of the anterior cerebral artery and accessory middle cerebral artery (Acc-MCA) is markedly rare. We report a rare case of an Acc-MCA aneurysm, and discuss the clinical course and management of this rare condition.

Case description: A 64-year-old man with a past history of cerebral infarction was revealed to have a left Acc-MCA and an aneurysm at its origin. The aneurysm was clipped via a transsylvian approach. Due to its location and projectile direction, the neck of the aneurysm was left partially unclipped.

Conclusion: Although an Acc-MCA aneurysm is very rare, it has a potential risk of rupture. Therefore, radical treatment is necessary for such aneurysms.

No MeSH data available.


Related in: MedlinePlus