PMC7553868_01
A: The first non-enhanced CT scan showed interhemisphere subdural hemorrahge.. B: The second non-enhanced CT scan showed interhemisphere subdural and intracerebral hemorrhage, with intraventricular hemorrhage.. C: The enhanced CT scan showed interhemisphere subdural and intracerebral hemorrhage, with intraventricular hemorrhage due to rupture of distal ACA.. D: The postoperative CT scan showed no subdural or subarachnoid hemorrhage, no hydrocephalus.
gr1.jpg
PMC7553868_01_gr1.jpg
fig0005
Non-enhanced computed tomography (CT) scan showed hemorrhage in frontal interhemispheric fissure (Fig. 1A). He had a brain CT scan showing subdural and intracerebral hematoma in the frontal lobe with intraventricular hemorrhage (Fig. 1B), then he was transfered to our hospital. The CT angiography showed an aneurysm at the distal anterior cerebral artery (ACA), with the dimension of 12 x 7 mm and the neck of 2 mm. (Figs. 1C and 2 A, B). Two days after the operation, the EVD was rejected after brain CT scan showed neither hydrocephalus nor intraventricular hemorrhage (IVH) (Fig. 1D).
A,B: The CT angiography showed an aneurysm in distal ACA. PcaA: Pericallosal artery. CmaA: Callosalmarginal artery. AN: Aneurysm. A2: A2 segment of ACA.
gr2.jpg
PMC7553868_01_gr2.jpg
fig0010
The CT angiography showed an aneurysm at the distal anterior cerebral artery (ACA), with the dimension of 12 x 7 mm and the neck of 2 mm. (Figs. 1C and 2 A, B).
The intraoperative image showed aneurysm in distal anterior cerebral artery. ACA: Anterior cerebral artery. AN: Aneurysm. A2: A2 segment of anterior cerebral artery.
gr3.jpg
PMC7553868_01_gr3.jpg
fig0015
Two mini-clips were placed on the neck of the aneurysm (Fig. 3).
The postoperative CT angiography showed clipping of aneurysm in distal cerebral artery. CmaA: Callosalmarginal artery.
gr4.jpg
PMC7553868_01_gr4.jpg
fig0020
Nine days after, computer tomography angiography (CTA) was done, showing no residual aneurysm, and no vasospasm (Fig. 4A,B).