• Hitoshi Shioya, Kenji Kikuchi, Yoshitaka Suda, Hidehiko Shoji, and Kenjiro Shindo.
• Department of Neurosurgery, Yuri Kumiai General Hospital, Akita, Japan.
• No Shinkei Geka. 2005 Feb 1; 33 (2): 155-62.

AbstractWe report a rare case of a ruptured internal carotid-posterior communicating artery (IC-PcomA) aneurysm associated with an anomalous hyperplastic anterior choroidal artery (AchoA) and aneuysm. A 64-year-old woman was admitted to our hospital because of a sudden onset of headache. CT scan showed subarachnoid hemorrhage. Left internal carotid angiograms showed a saccular aneurysm at the IC-PcomA region. Left posterior cerebral artery filling from the fetal type PcomA and an anomalous hyperplastic AchoA originating from the internal carotid artery (ICA) were also revealed. Left vertebral angiograms (Allcock test) revealed the left ICA and an anomalous hyperplastic AchoA via the fetal type PcomA. The patient was surgically treated through the left pterional transsylvian approach. The ruptured aneurysm was observed at the IC-PcomA region. The unruptured small aneurysm was found on just distal to the ruptured aneurysm. The PcomA and an anomalous hyperplastic AchoA were not observed behind the ICA. To prevent bleeding, the ruptured aneurysm and unruptured small aneurysm were clipped. Postoperative left internal carotid angiograms demonstrated no aneurysm was observed at the IC-PcomA region. The patency of the fetal type PcomA and an anomalous hyperplastic AchoA were preserved. The 7 reported cases of a intracranial aneurysm associated with an anomalous hyperplastic AchoA with our case are reviewed and their neuroradiological and clinical features are discussed.

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