Abstract
A successfully treated case of fusiform aneurysm arising from the Al portion of the anterior cerebral artery is reported. This 47-year-old man complained of the sudden onset of severe headache and vomiting on July 10, 1982. He was transferred to a local hospital and CT scan revealed subarachnoid hemorrhage at the basal cisterns. He was then referred to our hospital one month later. Enhancement CT scan showed a fusiform high-density area at the chiasma cistern. Left carotid angiography revealed a fusiform aneurysm of the proximal anterior cerebral artery 13×7mm in size. Elongation of the intracranial cerebral arteries and irregular deformity of the right proximal anterior cerebral artery were also found on the angiogram. He was operated on via the left pterional approach. The Al portion of the left anterior cerebral artery showed semifusiform configuration with the body behind the parent artery. There were no branches from the aneurysm itself. Sugita's angled fenestrated clip was successfully placed to form the parent artery. The postoperative course was uneventful, and the patient was discharged with mild neurological deficit one month after the operation.
Fusiform aneurysm involving the restricted segment of the anterior cerebral artery is quite rare, and only one such case has been reported. In this report, our case was described and surgical problems were discussed.
