A Case of Ruptured Fusiform Aneurysm at the Anomalous Bridging Vessel Connecting Left A2 Anterior Cerebral Artery and Accessory Anterior Cerebral Artery

Abstract

Accessory anterior cerebral artery (accessory ACA) is a type of median artery of anomalous triplicate ACA. Aneurysmal formation at accessory ACA is extremely rare. We report a case of ruptured fusiform aneurysm at the anomalous bridging vessel connecting lt. A2 and accessory anterior cerebral artery. A 32-year-old female presented with severe headache. Neurological examination was normal. Computed tomography showed diffuse subarachnoid hemorrhage. Left carotid angiography demonstrated the aneurysm arising from the anomalous bridging vessel. The shape of the anomalous bridging vessel looked like an aneurysm originating from lt. A2 and the dome attaching to the accessory ACA. We performed trapping for the fusiform aneurysm at the anomalous bridging vessel. The patient was ambulatory on discharge.