A case of anterior cerebral artery (A1) dissecting aneurysm presenting with subarachnoid hemorrhage

Abstract

Although increasing number of dissecting aneurysms of the intracranial artery have been reported, those of the anterior circuration are rare. We report a case of right anterior cerebral artery (A1) dissecting aneurysm presenting with subarachnoid hemorrhage. Intraoperative observation revealed that the vessel walls of A1 segment were dark in colour, a typical finding of dissecting aneurysm. A dissecting aneurysm in A1 segment was trapped with Sugita's clip. Thirty two cases of the anterior cerebral artery dissecting aneurysm from the literature have been analized. There is male prepoderance, with a male-to-female ratio of 22 to 10. All dissecting aneurysm in A1 segment eventually ruptured, resulting in subarachnoid hemorrhage shown on CT scan. In contrast, 17 of 20 cases with distal ACA disecting aneurysm presented cerebral infarction. Eight of 10 female cases have dissecting aneurysms in the A1 segment.