 |  |  |
| T1 pre-gad | T1 post-gad | T2 |
Diagnosis: Aneurysm of A1 segment of the left ACA
Saccular aneurysms are believed to be to due abnormal vascular hemodynamics while fusiform aneurysms are thought to be due to atherosclerotic disease. Associations with aneurysms include polycystic kidney disease, connective tissue disorders, and fibromuscular dysplasia. Symptoms are either from subarachnoid hemorrhage due to rupture or related to the mass affect of the aneurysm. Intracranial aneurysms are multiple in up to 1/5 of patients. 1/3 of aneurysms arise in the region of the ACOM and A1 segments while 20% arise in the region of the MCA trifurcation. Another 1/3 of intracranial aneurysms involve the supraclinoid ICA and PCOM region while the remainder are located in the posterior fossa. Specifically with regard to ACOM aneurysms, associated anomalies which may be seen include a hypoplastic contralateral A1 segment and a duplicated anterior communicator. If the angiogram were not available in this case the presence of phase encoding artifact, best seen on the T1 coronals post gad, is very helpful in establishing that there is flow within the aneurysm. Related Cases Inoue T, Matsushima T, Fujii K, Suzuki S, Fukui M, Hasuo K, Matsuno H. Microsurgical and angiographic analysis of anterior communicating artery aneurysms with associated anomalies. Fukuoka Igaku Zasshi, Nov 1992; 83(11):p397- 402.
