PMC5309442_01
CTA, 3D-CT, and artistic drawing, showing a 4 mm A5 segment aneurysm of the right ACA with rare configuration. Sagittal image (a), 3D reconstruction (b), and artistic drawing (c), showing the aneurysm (arrows)
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F1
A computed tomography angiogram (CTA) was performed, which showed a 4-mm right-sided pericallosal artery aneurysm, with a rare configuration [Figure 1].
Sagittal MRA image showing the aneurysm imbedded into the body of the corpus callosum (arrow)
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F2
The larger of the two terminal branches made a loop within the corpus callosum, where the aneurysm originated from, that was caudally projected, embedded into the body of the corpus callosum, forming a "pouch" in it [Figure 2].
Axial MRA image showing the bridging vein at the shortest trajectory projection of the aneurysm to the scull convex (arrow)
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F3
Because of the presence of a bridging vein at the shortest trajectory projection of the aneurysm to the scull convex that was visualized at the preoperative CTA and magnetic resonance angiogram (MRA), the approach was planned frontally to the vein [Figure 3].
Intraoperative view of parent artery (a) and the origin of the aneurysm, with its dome embedded into the body of the corpus callosum (b, arrows). The final clip was inserted after reshaping of the dome by bipolar coagulation (c, arrow)
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F4
The origin of the aneurysm was visualized, with its dome embedded into the body of the corpus callosum [Figure 4a and b]. Following careful dissection, a pilot clip was inserted to the aneurysm dome, which after reshaping of the dome by bipolar coagulation, was changed for a final clip [Figure 4c].