Clinical Features and Surgical Results of Distal Anterior Cerebral Artery Aneurysm

ABSTRACT

OBJECTIVE: Distal anterior cerebral artery(DACA) aneurysms are relatively uncommon, and have special aspects. We discuss clinical features and surgical results of DACA aneurysms with review of literatures. METHODS: Among 725 cases of intracranial aneurysms operated from 1989 to 2001 in our hospital, 38 cases of DACA aneurysms were studied retrospectively. The clinical presentations, neurological findings, operative approaches and outcome were analyzed. RESULTS: The incidence of the DACA aneurysm was 5.2% of total 725 aneurysms. Multiple aneurysms were found in 10 patients. Among the 38 patients, 15 were men and 23 were women. The mean age was 49.8 years. 2 aneurysms were located at frontobasal artery, 5 at the origin of frontopolar artery, 28 at the bifurcation between callosomarginal and pericallosal artery, 3 at the origin of pericallosal artery. 32 patients had good outcomes after surgery. 4 patients remained disabled, and 2 patients died. Postoperative complications were vasospasm, cerebral infarction, intracranial hemorrhage, pneumonia. CONCLUSION: The incidence of DACA aneurysm was relatively rare than other location. We think that unilateral interhemispheric approach is useful for aneurysm in most DACA, and approaches should be chosen according to the location of aneurysm and presence or absence of multiple aneurysms. The Glasgow Outcome Scale score was good in patient with low Hunt & Hess grade preoperatively. And early operation can reduce the rate of rebleeding and improve outcome of DACA aneurysms.