|Distal Anterior Cerebral Artery Aneyrysms (Pericallosal Artery): A Report of 19 Cases and Literature Review|
|Paulo Henrique Pires de Aguiar2, Iracema Araújo Estevão1, César Cozar Pacheco1, Marcos Vinicius Calfat Maldaun2, Carlos Tadeu Parisi de Oliveira3|
|1São Francisco University, School of Medicine, Bragança Paulista/SP,
2Santa Paula Hospital, Department of Neurosurgery, São Paulo,
3São Francisco Hospital School, Department of Neurosurgery, Bragança Paulista/SP,
Aim: The aim of this retrospective study was to evaluate the follow-up results of patients who received surgical treatment for distal anterior cerebral artery aneurysms (pericallosal artery) and correlate these findings with the literature. Material and Methods: During the period of 2000 to 2013, 19 cases were operated, conducted preoperative angiographic and CT study. To classify the CT findings were used Fisher and World Federation of Neuro Surgeons (WFNS) SAH grading scales. In addition to the clinical information, angiographic and tomographic analysis, it was performed bibliographical consultation in indexed databases. Results: Results show a 4:1 ratio of affected women to men with an average age of 34 years. In 53% of cases, the right side was affected, being 42% ruptured. According to Fishers classification, ruptured aneurysms were 25% Fisher IV, 37.5% Fisher III, 12.5% Fisher II and 25% Fisher I. According to WFNS were 50% Grade I, 12,5% Grade III and 37,5% Grade IV. The average size of the aneurysms was 3.5 mm ranging from 3 to 8 mm. One was fusiform and others were saccular. Considering location, 53% were in fronto polar and 47% in callosomarginal. Six cases were associated with multiple aneurysms. There was no mortality due to surgery. Conclusion: According to authors experience and references, pericallosal aneurysms should be considered having a better prognosis than aneurysms in other locations of the anterior circle of Willis. Complications are related to patients age and should always, as possible, be clipped due to potential risk of bleeding and difficulty of embolization.
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