PMC4901821_01
(a) Superoinferior view of the three-dimensional computed tomography angiogram, showing a saccular aneurysm arising from the left internal carotid artery bifurcation and an anomalous cortical branch originating from the left A1 segment of the anterior cerebral artery (black arrowheads). The anomalous artery runs anteromedially and then ascends superiorly and parallel to the right A2 segment of the anterior cerebral artery (black arrows). (b) Left lateral view of the three-dimensional computed tomography angiogram, showing the arterial course of an anomalous cortical branch originating from the left A1 segment of the anterior cerebral artery (white arrows) and its relationship to the bilateral A2 segment of the anterior cerebral artery. The artery runs parallel to the right A2 segment of the anterior cerebral artery (white double arrows). The left A2 segment of the anterior cerebral artery supplies the bihemispheric branches (white dotted arrow). A1: A1 segment of the anterior cerebral artery, A2: A2 segment of the anterior cerebral artery, BA: Basilar artery, IC: Internal carotid artery, Lt: Left, M1: M1 segment of the middle cerebral artery, Rt: Right, AN: Aneurysm
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F1
Three-dimensional CT angiography revealed a saccular aneurysm arising from the left internal carotid bifurcation, fenestration of the right P1 segment of the posterior cerebral artery, and an anomalous cortical branch originating from the left A1 segment of the ACA [Figure 1].
Lateral view of the right carotid arterial digital subtraction angiogram showing the arterial course of an anomalous cortical branch originating from the left A1 segment of the anterior cerebral artery. The artery has two main branches: The inferior branch forming the common trunk of the fronto-orbital (black dotted arrow), frontopolor (black arrow) and the anterior internal frontal arteries (black double arrows), and superior branch forming the callosomarginal branch of the anterior cerebral artery. The artery terminates in in medial internal frontal artery (white arrows)
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F2
Postoperative digital subtraction angiography confirmed complete aneurysm occlusion, showed the right A2 segment, and showed that the anomalous cortical branch originating from the left A1 segment of the ACA terminated at the medial internal frontal artery [Figure 2].