Ruptured Aneurysm At The Origin of The Median Artery of The Corpus Callosum: Case Report

摘要

Median artery of the corpus callosum (MACC) is a rare vascular variation and refers to the median artery of the triplicate A2 segments which supplies branches to the corpus callosum and adjacent cortex. The incidence of MACC in patients with anterior communicating artery (ACoA) aneurysms is rare. Here we describe a case of ruptured aneurysm which arose at the origin of a MACC. A 58-year-old female experienced a sudden headache, nausea and vomiting. The scale of Hunt-Hess was grade II. Computed tomography angiography (CTA) and digital subtraction angiography (DSA) showed an anomalous vessel originating from the ACoA complex. The vessel was identified as MACC. At the origin of the vessel was the fusiform-shaped aneurysm with a dome diameter of approximately 29.8mm × 9.8mm. Four weeks after the onset, a bifrontal craniotomy was performed to clip the aneurysm neck. The patient was discharged on the fifteenth postoperative day without neurological deficits. Post-operative three-month DSA did not find any abnormality. An 11-year follow-up showed that she was in a good condition with Karnofsky performance scale of 90. Since the ACoA complex is liable to vascular anomalies, preoperative and intraoperative care should be taken to identify the presence of anomalies of the ACoA complex to avoid accidental damage or clipping that may contribute to severe neurological deficits.