PMC4597291_01
Brain computed tomography scan revealed subarachnoid hemorrhage in basal cisterns and both sylvian fissures and anterior interhemispheric region. Dilated lateral ventricles and interstitial edema due to acute hydrocephalus is obvious
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F1
Emergent computed tomographic (CT) scan revealed SAH in the basal cisterns and both sylvian fissures and anterior interhemispheric region [Figure 1].
Four vessels digital subtraction angiography demonstrated a ruptured aneurysm of the left middle cerebral artery, an unruptured fusiform aneurysm of the right posterior communicating artery and an aneurysm at the site of the distal azygos anterior cerebral artery
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F2
Brain CT angiography and digital subtraction angiography of both internal carotid arteries (ICAs) and both vertebral arteries demonstrated a ruptured aneurysm of the left MCA and an unruptured fusiform aneurysm of right posterior communicating artery and an aneurysm at the site of the distal azygos anterior cerebral artery (ACA) [Figure 2].
Postoperative computed tomography angiography revealed an aneurysm at the site of the fenestration of the middle cerebral artery
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F3
After dissection of the aneurysm, fenestration of the MCA was exposed immediately at the aneurysm's site [Figure 3].
Postoperative computed tomography angiography revealed an aneurysm at the site of the right azygos A2 artery
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F4
The neurosurgeons opted for a right interhemispheric approach and a saccular aneurysm, with superolateral projection beneath the cingulate gyrus and 15 mm before bifurcation of the pericallosal and callosomarginal arteries was clipped with a 6 mm mini-clip [Figure 4].