Ureña Francisco Matos, Ureña Jose Gregorio Matos, Almeida Saul, Rabelo Nícollas Nunes, da Silva Julian Reis, Mandel Mauricio, Teixeira Manoel Jacobsen, Figueiredo Eberval Gadelha
Department of Neurosurgery, University of Sao Paulo, São Paulo.
Department of Neurosurgery, Atenas University Center, Paracatu, Minas Gerais, Brazil.
Surg Neurol Int. 2020 Mar 6;11:36. doi: 10.25259/SNI_515_2019. eCollection 2020.
The anterior communicating artery complex may presente several anatomical variations, and many abnormalities have been reported in radiologiacal and cadaveric studies.
The authors present a case of a 44-year-old Caucasian female, with a prior history of smoking and arterial systemic hypertension, admitted in the emergency department complaining of a sudden headache, nausea, and vomiting followed by tonic-clonic seizures. Computerized tomography (CT) and angiography (angio- CT) were carried out and showed Fisher Grade IV subarachnoid hemorrhage. Angio-CT revealed an anterior communicating artery (AComA) aneurysm. Minimally invasive craniotomy and microsurgical clipping were performed uneventfully. An unusual anatomical variation of the AComA complex characterized by duplication of the AComA associated with a triplication of anterior cerebral artery (ACA) was observed. The patient was discharged with no neurological deficits.
This unique anatomical variation of the AComA-ACA complex constitute risck factors for development and rupture of aneurysms.
前交通动脉复合体可能存在多种解剖变异，放射学和尸体研究中已报道了许多异常情况。
作者报告了一例44岁的白种女性病例，该患者有吸烟和动脉性全身性高血压病史，因突发头痛、恶心、呕吐，随后出现强直阵挛性发作而入住急诊科。进行了计算机断层扫描（CT）和血管造影（CT血管造影），显示为Fisher Ⅳ级蛛网膜下腔出血。CT血管造影显示前交通动脉（AComA）动脉瘤。顺利进行了微创开颅和显微手术夹闭。观察到AComA复合体一种不寻常的解剖变异，其特征为AComA重复并伴有大脑前动脉（ACA）三联征。患者出院时无神经功能缺损。
AComA-ACA复合体这种独特的解剖变异是动脉瘤发生和破裂的危险因素。
