Anterior communicating artery duplication associated with a triplication of anterior cerebral artery - A rare anatomical variation

Abstract

Background: The anterior communicating artery complex may presente several anatomical variations, and many abnormalities have been reported in radiologiacal and cadaveric studies. Case Description: The authors present a case of a 44-year-old Caucasian female, with a prior history of smoking and arterial systemic hypertension, admitted in the emergency department complaining of a sudden headache, nausea, and vomiting followed by tonic-clonic seizures. Computerized tomography (CT) and angiography (angio-CT) were carried out and showed Fisher Grade IV subarachnoid hemorrhage. Angio-CT revealed an anterior communicating artery (AComA) aneurysm. Minimally invasive craniotomy and microsurgical clipping were performed uneventfully. An unusual anatomical variation of the AComA complex characterized by duplication of the AComA associated with a triplication of anterior cerebral artery (ACA) was observed. The patient was discharged with no neurological deficits. Concluision: This unique anatomical variation of the AComA-ACA complex constitute risck factors for development and rupture of aneurysms.