Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
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"Occult" Ruptured Infectious Aneurysm of the Distal Anterior Cerebral Artery - Case Report -

  • Ahn, Duck-Hyung (Department of Neurosurgery, School of Medicine, Institute of Wonkwang Medical Science, Wonkwang University) ;
  • Kim, Dae-Won (Department of Neurosurgery, School of Medicine, Institute of Wonkwang Medical Science, Wonkwang University) ;
  • Kang, Sung-Don (Department of Neurosurgery, School of Medicine, Institute of Wonkwang Medical Science, Wonkwang University)
  • Published : 2009.12.30

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Abstract

A 58-year-old man who underwent mitral valve replacement for mitral valve prolapse that was complicated by severe mitral regurgitation was referred to our department due to his sudden onset of drowsiness. Brain computed tomography revealed a hemorrhage in the anterior interhemispheric fissure and left frontal lobe. Cerebral angiography demonstrated a saccular aneurysm at the angular branch of the middle cerebral artery (MCA), but there was no evidence of vascular abnormalities at the hemorrhagic area. End-to-end anastomosis of the angular branch was performed after resection of the friable aneurysm and the perianeurysmal parent artery segment. Follow-up cerebral angiography after three weeks showed an aneurysm in the distal anterior cerebral artery (ACA) in the previously hemorrhagic area. This ruptured aneurysm was successfully clipped. An infectious aneurysm was confirmed on the histopathological examination.

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