A 49-year-old woman presented with a sudden onset of right hemiparesis and motor aphasia. Computed tomography (CT) and magnetic resonance imaging (MRI) showed subarachnoid hemorrhage (SAH) localized in the interhemispheric fissure and cerebral infarction in the territory of the left anterior cerebral artery (ACA). Digital subtraction angiography (DSA) demonstrated segmental narrowing and dilatation at the left A2 segment, leading to a diagnosis of ACA dissection.
The day after the onset, we planed trapping of the dissecting portion and A3–A3 side-to-side anastomosis. As a result, we performed only the wrapping of the dissection portion, because the dissection was longer than we expected. Neither aneurysmal dilatation nor narrowing progressed almost six months after the operation.
This case indicates wrapping is also effective as a treatment of dissecting aneurysms, and it is important to consider longer-than-expected ACA dissections.
