Korean J Cerebrovasc Surg.  2009 Dec;11(4):145-149.

"Occult" Ruptured Infectious Aneurysm of the Distal Anterior Cerebral Artery: Case Report

• Ahn DH
• Kim DW
• Kang SD

Abstract

A 58-year-old man who underwent mitral valve replacement for mitral valve prolapse that was complicated by severe mitral regurgitation was referred to our department due to his sudden onset of drowsiness. Brain computed tomography revealed a hemorrhage in the anterior interhemispheric fissure and left frontal lobe. Cerebral angiography demonstrated a saccular aneurysm at the angular branch of the middle cerebral artery (MCA), but there was no evidence of vascular abnormalities at the hemorrhagic area. End-to-end anastomosis of the angular branch was performed after resection of the friable aneurysm and the perianeurysmal parent artery segment. Follow-up cerebral angiography after three weeks showed an aneurysm in the distal anterior cerebral artery (ACA) in the previously hemorrhagic area. This ruptured aneurysm was successfully clipped. An infectious aneurysm was confirmed on the histopathological examination.

Keyword

Infectious aneurysm; Occult

MeSH Terms

Aneurysm
Aneurysm, Ruptured
Anterior Cerebral Artery
Arteries
Brain
Cerebral Angiography
Follow-Up Studies
Frontal Lobe
Hemorrhage
Humans
Middle Aged
Middle Cerebral Artery
Mitral Valve
Mitral Valve Insufficiency
Mitral Valve Prolapse
Parents
Sleep Stages