• Dae-Hee Seo, Won-Cheol Lee, Il-Seung Choe, Sung-Choon Park, and Young-Soo Ha.
• Department of Neurosurgery, Myongji Hospital, Kwandong University School of Medicine, Koyang, Korea. nsdrseo@kwandong.ac.kr
• Neurol India. 2009 Jan 1; 57 (1): 85-7.

AbstractAnterior communicating artery (Acom) complex and anterior cerebral artery (ACA) are the frequent sites of arterial anomalies. Aneurysms associated with triplicate ACA are rare. Blood blister-like aneurysm (BBA) of the Acom is also very rare. This report presents these two rare types of aneurysms in a 63-year old man who presented with subarchnoid hemorrhage secondary to accessory ACA aneurysmal rupture. During surgery, a BBA of the Acom was also found. Both the aneurysms were treated simultaneously. The BBA bled intraprocedurally but was repaired successfully by neck reconstruction and clipping with the preservation of the parent and the branching arteries. The ruptured accessory ACA aneurysm was clipped together with the artery which had multiple aneurysms distally. For the treatment of a complex aneurysm like this, accurate understanding of the anatomic variations, proper imaging study and extremely careful technique are essential.

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