Abstract
We report on a patient in whom the right posterior cerebral artery-posterior communicating artery junction (PC-Pcom junction) aneurysm was associated with bilateral carotid occlusion. She had been in good health until when she had admitted to our facility immediately after loss of consciousness. Computed tomography revealed subarachnoid hemorrhage (SAH). Cerebral angiography demonstrated an aneurysm arising from the right PC-Pcom junction. Bilateral carotid arteries were occluded 2-3cm from bifurcations. Anterior circulation was supplied with the vertebro-basilar system. The cerebral aneurysm was located in the posterior circulation where the hemodynamic stress might have occurred. High resolution computed tomography demonstrated the presence of bilateral carotid canals in the skull base. Thirty-seven days after onset, neck clipping of the aneurysm was carried out through the right pterional approach. We could not perform STA-MCA anastomosis because of poor filling of the external carotid artery. Postoperative angiography showed disappearance of the aneurysm and good filling of the posterior communicating artery. The patient returned home 16 days after surgery with no neurological deficits.
