Aneurysm of azygous anterior cerebral artery

Case report

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✓ This report describes a patient with a fusiform aneurysm of an azygous anterior cerebral artery (ACA) associated with a ruptured saccular aneurysm at its distal end. Gross, microscopic, and radiological documentation of this anomaly is presented. It is suggested that in cases where the question of an unpaired ACA arises, a projection paralleling the radiological baseline be employed during angiographic studies thus affording better visualization of these vessels. Clinically, in patients with pericallosal aneurysms, their frequent association with azygous ACA's should be borne in mind, as injury to this common arterial trunk will affect both hemispheres and the corpus callosum with tragic results.

Article Information

Address reprint requests to: Dikran S. Horoupian, M.D., Department of Pathology (Neuropathology), Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York 10461.

© AANS, except where prohibited by US copyright law.

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Figures

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    Right carotid angiograms. Left: Anteroposterior Towne view. A = the dilated azygous trunk distal to the aneurysm; B = the aneurysm; arrows indicate the small vessel paralleling the course of the azygous vessel distal to the aneurysm. Note also the filling of the left A1 segment of the anterior cerebral artery via reflux, and segmental narrowing in various areas, particularly in the distal right A1, and in the middle cerebral artery. Right: Lateral view. Arrow indicates the saccular aneurysm of the azygous anterior cerebral artery. There is an infundibular widening of the origin of the anterior choroidal artery. Segmental narrowing of the anterior and middle cerebral vessels can be appreciated in this view also.

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    Circle of Willis, fixed in formalin. A = the aneurysmal azygous anterior cerebral artery; B = the multilobulated saccular aneurysm at its distal end.

References

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