PMC4597300_01
(a) Three-dimensional computed tomography angiography showing an aneurysm (arrow) at the origin of an accessory middle cerebral artery (arrowheads). (b) Angiography demonstrating an aneurysm (arrow) at the junction of A1 of the anterior cerebral artery and accessory middle cerebral artery. The accessory middle cerebral artery (arrowheads) runs laterally along with the middle cerebral artery. (c) An intra-operative photograph showing an aneurysm (arrow) at the origin of the accessory middle cerebral artery (arrowheads). The aneurysm is projecting medially. (d) An intra-operative photograph showing that the aneurysm is clipped. (e) Follow-up angiography obtained 27 months after the operation, showing a small residual neck of the aneurysm
SNI-6-421-g001.jpg
PMC4597300_01_SNI-6-421-g001.jpg
F1
Three-dimensional computed tomography angiography [Figure 1a] and angiography [Figure 1b] demonstrated an anomalous artery originating from the left A1 of the ACA. The aneurysm was found to project supramedially to the ACA [Figure 1c]; therefore, the neck was relatively difficult to observe and remained partially unclipped [Figure 1d]. Follow-up angiography [Figure 1e] performed 27 months after the operation showed no recurrence or enlargement of the aneurysm.