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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(03): 536-539
DOI: 10.1055/s-0043-1776990
Case Report

A Rare Case of Unruptured Small Aneurysm Arising from the Posterior Surface of Proximal A1 Segment, Projecting Posterior-Inferiorly and Entangled with Multiple Perforators from the A1 Segment

Samir Jagannath Kale
1   Department of Neurosurgery, Dr. D. Y. Patil Medical College and Hospital, Mumbai, Maharashtra, India
,
Riki Tanaka
2   Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Aichi, Japan
,
Mai Okubo
2   Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Aichi, Japan
,
Kento Sasaki 
2   Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Aichi, Japan
,
Kyosuke Miyatani
2   Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Aichi, Japan
,
Yasuhiro Yamada
2   Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Aichi, Japan
,
Fuminari Komatsu 
2   Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Aichi, Japan
,
Yoko Kato
2   Department of Neurosurgery, Fujita Health University, Bantane Hospital, Nagoya, Aichi, Japan
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Abstract

Aneurysm arising from the A1 segment of the anterior cerebral artery is rare. Aneurysm of the A1 segment even being small tend to rupture early. They tend to develop along the with various vascular anomalies of the vessels arising from the A1 segment. Use of computational fluid dynamics and hemodynamic consideration is of importance in this aneurysm. In this report we describe a 57-year-old woman with a small, unruptured A1 segment aneurysm arising from the proximal segment of the posterior surface of A1, and pointing posterior-inferiorly with multiple perforators entangling around for which microsurgical clipping was done. Intraoperative clipping of the aneurysm and salvaging the multiple perforators were challenging. We report a rare case of an A1 segment aneurysm arising from the posterior surface facing with multiple perforators. It is of significance to understand that a small, unruptured A1 aneurysm can arise from the posterior surface of the A1 segment with projection posterior-inferiorly making it deeper in location with multiple perforators entangling it; hence, it is challenging to treat without causing neurological deficits.

Keywords

proximal A1 segment - posterior-inferiorly - perforators - computational fluid dynamics - motor-evoked potential (MEP)


Publication History

Article published online:
04 July 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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