Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Dissecting aneurysms of the anterior cerebral artery and accessory middle cerebral artery. Case report


A 66-year-old woman presented with dissecting aneurysms of the anterior cerebral artery (ACA) and accessory middle cerebral artery (MCA) manifesting as subarachnoid hemorrhage but without radiological evidence of the dissecting aneurysms. Intraoperative observation revealed that the vessel walls were dark purple in color, a typical finding of dissecting aneurysm. The abnormal A1 segment was trapped and the dissecting aneurysm of the accessory MCA was wrapped. In the case of SAH of unknown origin, dissecting aneurysm should always be kept in mind even if the angiogram does not show any abnormal finding. This is the first reported case of dissecting aneurysm of the accessory MCA.

This is a preview of subscription content, log in to check access.


  1. [1]

    Adams HP Jr, CA Aschenbrener, NF Kassel, L Ansbacher, SH Cornell: Intracranial hemorrhage produced by spontaneous dissecting intracranial aneurysm. Arch Neurol 39 (1982) 773–776

  2. [2]

    Amagasa M, S Sato, K Otage: Posttraumatic dissecting aneurysm of the anterior cerebral artery: case report. Neurosurgery 23 (1988) 221–225

  3. [3]

    Engeset A, JW Nelson, AW Munthe-Kaas: Acute cerebral vascular insufficiency in young patients. Acta Neurol Scand 43, Suppl 31 (1967) 122

  4. [4]

    Friedman AH: Arterial dissections. In:Wilkins RH, SS Rengachary (eds): Neurosurgery McGraw-Hill, New York 1985

  5. [5]

    Gherardi GJ, HY Lee: Localized dissecting hemorrhage and arteritis. JAMA 199 (1967) 187–188

  6. [6]

    Grosman H, VL Fornasier, D Bonder, KE Livingston, ME Platts: Dissecting aneurysm of the cerebral arteries. J Neurosurg 53 (1980)

  7. [7]

    Guridi J, J Gallego, F Monzon, F Aguilera: Intracerebral hemorrhage caused by transmural dissection of the anterior cerebral artery. Stroke 24 (1993) 1400–1402

  8. [8]

    Hochberg FH, C Bean, M Fisher, GH Roberson: Stroke in a 15-year-old girl secondary to terminal carotid dissection. Neurology 25 (1975) 725–729

  9. [9]

    Ishikawa R, S Sunagawa, I Itoh, K Iwashita: An experience of dissecting cerebral aneurysm of the anterior cerebral artery. No Shinkei Geka 21 (1993) 355–359

  10. [10]

    Kidooka M, T Okada, M Sonobe, T Nakazawa, J Handa: Dissecting aneurysm of the anterior cerebral artery: report of two cases. Surg Neurol 39 (1993) 53–57

  11. [11]

    Krayenbuhl H, MG Yasargil (eds): Cerebral angiography (2nd ed). Georg Thieme Verlag, Stuttgart-New York 1968.

  12. [12]

    Kunze ST, W Schiefer: Angiographic demonstration of a dissecting aneurysm of the middle cerebral artery. Neuroradiology 2 (1971) 201–206

  13. [13]

    Linden MD, SM Chou, AJ Furlan, JP Conomy: Cerebral arterial dissection — a case report with histopathologic and ultrastructural findings. Cleve Clin J Med 54 (1987) 105–114

  14. [14]

    Nakazawa T, A Saito, K Watanabe, M Matsuda, J Handa: Dissecting aneurysm of the anterior cerebral artery: report of a case. No Shinkei Geka 12 (1984) 1211–1216

  15. [15]

    Nelson JW, OB Styri: Dissecting subintimal hematomas of the intracranial arteries: report of a case. J Am Osteopath Assoc 67 (1968) 512–517

  16. [16]

    Nomura H, M Nishijima, S Hounoki, N Oka, A Takaku: A dissecting aneurysm of the anterior cerebral artery: a case report and a review of the literature. Jpn J Neurosurg (Tokyo) 2 (1993) 152–156

  17. [17]

    Otawara Y, K Miura, M Suzuki, A Ogawa, K Yamazaki, H Tohgi: A case of spontaneous cervical carotid artery dissection. No To Shinkei 47 (1995) 277–280

  18. [18]

    Pilz P: Dissezierendes Aneurysma der Arteria cerebri anterior und Guillain-Barre-Syndrom in der Schwangerschaft. J Neurol 214 (1977) 295–299

  19. [19]

    Rinkel GJE, J Gijn, EFM Wijdicks: Subarachnoid hemorrhage without detectable aneurysm. A review of the causes. Stroke 24 (1993) 1403–1409

  20. [20]

    Sasaki O, T Koike, S Takeuchi, R Tanaka: Serial angiography in a spontaneous dissecting anterior cerebral artery aneurysm. Surg Neurol 36 (1991) 49–53

  21. [21]

    Stiener H, J Lammer, R Kleinert, H Schreyer: Dissecting aneurysm of cerebral arteries in congenital vascular deficiency. Neuroradiology 28 (1986) 331–334

  22. [22]

    Terai S, T Matsubara: A case of dissecting aneurysm involving solely anterior cerebral artery. Jpn J Stroke 13 (1991) 159–164

  23. [23]

    Umansky F, M Dujovny, JI Ausman, F Diaz, H Mirchandani: Anomalies and variations of the middle cerebral artery: a microanatomical study. Neurosurgery 22 (1988) 1023–1027

  24. [24]

    Wolman L: Cerebral dissecting aneurysms. Brain 82 (1959) 276–291

  25. [25]

    Yamashita M, K Tanaka, T Matsuo, K Yokoyama, T Fujii, H Sakamoto: Cerebral dissecting aneurysms in patients with moyamoya disease — report of two cases. J Neurosurg 58 (1983) 120–125

  26. [26]

    Yang H, M Sawada, J Shinoda, T Funakoshi: Ruptured dissecting aneurysm of the peripheral anterior cerebral artery — case report. Neurol Med Chir (Tokyo) 35 (1995) 450–453

Download references

Author information

Correspondence to Yasunari Otawara M. D..

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Otawara, Y., Suzuki, M., Abe, M. et al. Dissecting aneurysms of the anterior cerebral artery and accessory middle cerebral artery. Case report. Neurosurg. Rev. 20, 145–148 (1997). https://doi.org/10.1007/BF01138201

Download citation


  • Accessory middle cerebral artery
  • anterior cerebral artery
  • dissecting aneurysm
  • subarachnoid hemorrhage