case_images: PMC4496835_01
case_images: (a) Three-dimensional digital subtraction angiography (DSA) showing the elongated and tortuous left internal cerebral artery (ICA) with saccular aneurysms (white arrow). (b) Postoperative DSA showing successful clipping of these aneurysms. Intraoperative photographs (c and d) and illustrations. (e and f) Enlarged and tortuous left ICA with saccular aneurysms (arrow), and successful clipping of these aneurysms
case_images: SNI-6-291-g001.jpg
case_images: PMC4496835_01_SNI-6-291-g001.jpg
case_images: F1
case_images: C2) on the left side and saccular aneurysms in the left C1. Cerebral angiography revealed that the ICA coiled twice between the ophthalmic artery and the anterior choroidal artery and contained four saccular aneurysms distal to the posterior communicating artery [Figure 1a]. During temporary occlusion of the ICA, the artery collapsed completely; no arterial dissection or atherosclerotic changes were observed [Figure 1c and e]. Accordingly, the aneurysm was successfully clipped at the neck [Figure 1d and f]. Postoperative angiogram revealed obliteration of the aneurysmal neck and the absence of residual opacification [Figure 1b].
case_images: PMC4496835_02
case_images: (a) Digital subtraction angiography (DSA) showing the elongated and tortuous left anterior cerebral artery (ACA) with saccular aneurysm (white arrow). (b) Postoperative DSA showing successful clipping of the aneurysm. Preoperative three-dimensional computed tomographic angiography (c and d), intraoperative photographs (e and f) and illustrations. (g and h) Enlarged and tortuous left ACA with saccular aneurysm (arrow), and successful clipping of the aneurysm
case_images: SNI-6-291-g002.jpg
case_images: PMC4496835_02_SNI-6-291-g002.jpg
case_images: F2
case_images: ACA (A1) on the left side and a saccular aneurysm in the left A1 segment [Figure 2a, c and d]. All other intracranial vessels appeared completely normal. The left A1 was dilated, elongated, and tortuous [Figure 2e, f, and g]. The neck of the aneurysm was apparent, however, and the aneurysm was successfully clipped at the neck [Figure 2f and h]. Postoperative angiogram revealed complete clipping of the aneurysm [Figure 2b].