Pericallosal berry aneurysm associated with azygous anterior cerebral artery – a case report

Authors

DOI:

https://doi.org/10.15584/ejcem.2021.3.9

Keywords:

azygos ACA, berry aneurysm, magnetic resonance angiography

Abstract

Introduction. Azygos anterior cerebral artery is a rare variant of the anterior segment of the circle of Willis caused by an unusual fusion of the normally paired A2 segments of the anterior cerebral artery (ACA). Despite its rare occurrence, it is associated with various vascular and structural cerebral abnormalities, particularly berry aneurysms.

Aim. We aimed to present a case of a 41-year-old female patient who presented to our neurology department with complaints of headache.

Description of the case. She had a positive paternal history of aneurysmal subarachnoid hemorrhage. Magnetic resonance angiography (MRA) of her brain revealed an azygos ACA (bifurcating into two pericallosal arteries) which was associated with a saccular aneurysm at its bifurcation point. She was referred to the interventional radiology department for preventive endovascular treatment.

Conclusion. Azygos ACA carries a high risk of aneurysm development and its occlusion can potentially compromise blood supply to both cerebral hemispheres. It is therefore crucial for clinicians to be aware of its significance and to report its presence in angiographic studies.

Downloads

Download data is not yet available.

References

Dimmick SJ, Faulder KC. Normal variants of the cerebral circulation at multidetector CT angiography. Radiographics. 2009;29(4):1027-1043.

Schick RM, Rumbaugh CL. Saccular aneurysm of the azygos anterior cerebral artery. AJNR Am J Neuroradiol. 1989;10(5):73.

Huh JS, Park SK, Shin JJ, et al. Saccular aneurysm of the azygos anterior cerebral artery: three case reports. J Korean Neurosurg Soc. 2007;42(4):342-345.

Kaspera W, Ładziński P, Słowiński J, et al. Blood flow velocity in the arteries of the anterior cerebral artery complex in patients with an azygos anterior cerebral artery aneurysm: a transcranial color-coded sonography study. Clin Neurol Neurosurg. 2009;111(1):63-68.

Singh H, Dhandapani S, Mathuriya SN. Types of Azygos Distal Anterior Cerebral Artery Branching Patterns: Relevance in Aneurysmal Surgery. Cureus. 2016;8(7):e681.

Takahashi S. Neurovascular Imaging, MRI & Microangiography. Springer Verlag. 2010.

Katz RW, Horoupian DS, Zingesser L. Aneurysm of azygous anterior cerebral artery. A case report. J Neurosurg. 1978;48(5):804-808.

Ghanta RK, Kesanakurthy MV, Vemuri VN. Aneurysm of azygos anterior cerebral artery: A report of two cases. Asian J Neurosurg. 2016;11(3):312.

Beyhan M, Gökçe E, Karakuş K. Radiological classification of azygos anterior cerebral artery and evaluation of the accompanying vascular anomalies. Surg Radiol Anat. 2020;42(11):1345-1354.

Szdzuy D, Lehmann R, Nickel B. Common trunk of the anterior cerebral arteries. Neuroradiology. 1972;4(1):51-56.

Downloads

Published

2021-09-30

How to Cite

Erok, B., Win, N. N., & Tatar, S. (2021). Pericallosal berry aneurysm associated with azygous anterior cerebral artery – a case report. European Journal of Clinical and Experimental Medicine, 19(3), 259–261. https://doi.org/10.15584/ejcem.2021.3.9

Issue

Section

CASUISTIC PAPERS