case_images: PMC10783670_01
case_images: (a) Plain computed tomography (CT) of the brain revealed a subarachnoid hemorrhage and hematoma in the interhemispheric fissure. (b and c) CT angiography of sagittal view (b) and 3D digital subtraction angiography (c) showed an aneurysm at the A4-A5 junction. (d and e) Right internal cerebral artery angiogram showed a bihemispheric type anterior cerebral artery and a saccular aneurysm. (f) Postoperative angiogram showed complete obliteration of the aneurysm.
case_images: SNI-14-444-g001.jpg
case_images: PMC10783670_01_SNI-14-444-g001.jpg
case_images: F1
case_images: Computed tomography (CT) of the brain revealed a subarachnoid hemorrhage (SAH) and hematoma in the interhemispheric fissure [Figure 1a]. CT angiography (CTA) showed a saccular aneurysm in the DACA (A4-A5 portion) [Figure 1b]. Right internal carotid angiography revealed a bihemispheric anterior cerebral artery (ACA) and an aneurysm in the supracallosal portion [Figures 1c-e]. Aichi, Japan). Coil embolization was performed with four coils using a simple technique, resulting in complete obliteration [Figure 1f]. A total of 4ED Extrasoft coils of helical type were deployed (Kaneka Medix, Osaka, Japan). After rehabilitation, the patient was discharged with a modified Rankin
case_images: PMC10783670_02
case_images: (a) Initial computed tomography (CT) of the brain showed intracerebral hemorrhage and subarachnoid hemorrhage in the cingulate gyrus. (b and c) CT angiography of sagittal view (b) and 3D digital subtraction angiography (c) showed a saccular aneurysm at the A3-A4 junction. (d and e) Right internal cerebral artery angiogram showed an accessory anterior cerebral artery and a saccular aneurysm. (f) Postoperative angiogram showed complete obliteration of the aneurysm.
case_images: SNI-14-444-g002.jpg
case_images: PMC10783670_02_SNI-14-444-g002.jpg
case_images: F2
case_images: Brain CT revealed intracerebral hemorrhage and SAH from the corpus callosum to the cingulate gyrus [Figure 2a], and CTA revealed a saccular aneurysm in the DACA [Figure 2b]. 3D digital subtraction angiography indicated an aneurysm in A4 of the accessory ACA, which was bihemispheric type ACA [Figures 2c and d]. The aneurysm had a maximum diameter of 5 mm at its widest point but was 2.5 mm deep with a wide neck and cortical branches branching from the neck [Figure 2e]. A headway Duo microcatheter (MicroVention/Terumo, Tustin, CA, USA) was guided into the aneurysm using a 0.014-inch CHIKAI guidewire. Coil embolization was performed with six coils using a simple technique [Figure 2f].