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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(03): 927-929
DOI: 10.4103/ajns.AJNS_34_19
Case Report

Surgical significance of infra-optic course of A1 segment of anterior cerebral artery: Report of two cases

H Nandish
Department of Neurosurgery, Saveetha Medical College, Chennai, Tamil Nadu
,
Srinivasalu Selvapandian
1   Department of Neurosurgery, Apollo Speciality Hospitals, Chennai, Tamil Nadu
,
Siddhartha Ghosh
1   Department of Neurosurgery, Apollo Speciality Hospitals, Chennai, Tamil Nadu
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Anatomic variations of the anterior cerebral artery-anterior communicating artery complex (ACA-AComA) are common. An infra-optic course of the A1-ACA is extremely rare, and recognition of this variant is very important in planning surgery for ACA-AComA complex aneurysms. We present two cases of spontaneous subarachnoid hemorrhage due to ruptured AComA aneurysms with unilateral infra-optic course of the A1-ACA. In both the cases, the preoperative catheter angiography revealed low bifurcation with a horizontal course of internal carotid artery. In our first case, the finding was rather unexpected; however, in our second case, we could anticipate an infra-optic course of A1-ACA. Preoperative recognition of this anomaly helps in achieving proximal vascular control with ease and confidence. It also enhances surgical safety of aneurysm clipping, by avoiding unnecessary dissection elsewhere. This emphasizes the importance of careful preoperative angiographic evaluation. In the presence of this anomaly, one should always search for other associated vascular anomalies.

Key-words:

Aneurysm clipping - anterior communicating artery aneurysm - infra-optic A1 segment of anterior cerebral artery - precommunicating segment of anterior cerebral artery

Financial support and sponsorship

Nil.




Publikationsverlauf

Artikel online veröffentlicht:
09. September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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