Sharafeddin Fransua, Hafez Ahmad, Lehecka Martin, Raj Rahul, Colasanti Roberto, Rafiei Ahmadreza, Choque Joham, Jahromi Behnam R, Niemelä Mika, Hernesniemi Juha
Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland.
Surg Neurol Int. 2017 Feb 6;8:18. doi: 10.4103/2152-7806.199559. eCollection 2017.
The A5 segment aneurysms of the anterior cerebral artery are rare, approximately 0.5% of all intracranial aneurysms. They are small with a wide base located in the midline, with the domes mostly projecting upward or backward.
The authors describe a unique case of A5 segment aneurysm, with the dome embedded into the body of the corpus callosum. This 41-year-old female was admitted to the neurology department for possible multiple sclerosis investigation. Computed tomography angiogram (CTA) revealed a 4-mm right-sided pericallosal artery aneurysm, with rare configuration, which was caudally projected, embedded into the body of the corpus callosum. Considering the family history, patient underwent a prophylactic ligation surgery. The postoperative CT and CTA showed no complication and successful occlusion of the aneurysm with no ischemia or hemorrhage in the corpus callosum.
To the best of our knowledge, this is the first case of an aneurysm with this configuration. Our rare case of A5 segment aneurysm demonstrates the importance of planning of the surgery, choosing the appropriate approach, and knowing the detailed anatomy of the region, as well as the necessity of microsurgical clipping of small unruptured AdistAs.
大脑前动脉A5段动脉瘤罕见，约占所有颅内动脉瘤的0.5%。它们体积小，基底宽，位于中线，瘤顶大多向上或向后突出。
作者描述了一例独特的A5段动脉瘤病例，瘤顶嵌入胼胝体。这位41岁女性因可能的多发性硬化症检查入住神经内科。计算机断层血管造影（CTA）显示右侧胼周动脉有一个4毫米的动脉瘤，形态罕见，向尾侧突出，嵌入胼胝体。考虑到家族史，患者接受了预防性结扎手术。术后CT和CTA显示无并发症，动脉瘤成功闭塞，胼胝体无缺血或出血。
据我们所知，这是首例具有这种形态的动脉瘤病例。我们这例罕见的A5段动脉瘤病例表明了手术规划、选择合适入路、了解该区域详细解剖结构的重要性，以及对小型未破裂A5段动脉瘤进行显微手术夹闭的必要性。
