Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Ruptured Aneurysm Arising from the Distal End of a Proximal A1 Fenestration : Case Report and Review of the Literature

  • Koh, Jun-Seok (Department of Neurosurgery, Stroke and Neurological Disorders Centre, East-West Neo Medical Hospital, Kyung Hee University School of Medicine) ;
  • Kim, Eui-Jong (Department of Radiology, Medical Center of Kyung Hee University, Kyung Hee University School of Medicine) ;
  • Lee, Seung-Hwan (Department of Neurosurgery, Stroke and Neurological Disorders Centre, East-West Neo Medical Hospital, Kyung Hee University School of Medicine) ;
  • Bang, Jae-Seung (Department of Neurosurgery, Stroke and Neurological Disorders Centre, East-West Neo Medical Hospital, Kyung Hee University School of Medicine)
  • Published : 2009.01.28
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Abstract

A 75-year-old female presented with subarachnoid hemorrhage. Angiography revealed a partial duplication (fenestration) in the proximal $A_1$ segment and a ruptured aneurysm at the distal end of $A_1$ fenestration. This congenital anomaly accompanying an aneurysm was associated with duplicated ipsilateral middle cerebral artery (MCA). Congenital defect of the arterial wall and hemodynamic factors at the fenestrated $A_1$ are considered to play a significant role in the development of this aneurysm. The present case is peculiar because not only the ruptured $A_1$ aneurysm was related with the anterior and middle cerebral artery duplication but also the location of $A_1$ fenestration and the origin of $A_1$ aneurysm in a fenestration are quite unusual.

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References

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