Endovascular treatment of A1 aneurysms. A series of five cases with a brief literature review.

Aneurysms of the A1 segment of the anterior cerebral artery are rare and represent less than 1% of intracranial aneurysms. There are few reports available in the literature describing the role of endovascular management of these rare aneurysms. In the present series we describe five patients with A1 aneurysms presenting at our institution with various clinical presentations, treated successfully by endovascular method with a good clinical outcome. From January 2008 to July 2011, five patients (two males and three females) with A1 aneurysms were treated by endovascular means. Four of the patients presented with subarachnoid hemorrhage due to rupture of the A1 aneurysm and one patient presented with symptoms of mass effect in the form of headache and ophthalmoplegia. The age group ranges from eight to 52 years with a mean age of 34.2 years. Four of the patients were treated by coiling without any assisted technique whereas one patient who had a dissecting fusiform aneurysm was treated with stent-assisted coiling. Technical success was achieved in all the patients.We did not encounter any procedure-related complications in any of our cases. All the patients had an uneventful course with good clinical outcome. Angiographic follow-up was available in four patients (80%). Endovascular treatment of this rare group of aneurysms is an effective and safe treatment modality, however large series are required to support our findings.

Endovascular treatment of ruptured intradural ophthalmic artery aneurysm. A case report and literature review.

We present a unique case of ruptured intradural ophthalmic artery aneurysm in a young man who presented with subarachnoid hemorrhage. By endovascular technique we successfully excluded the aneurysm from the circulation with preservation of antegrade flow in the ophthalmic artery. The presenting features and the technique of the treatment are described with a review of the literature.

Diagnosis of Intracranial Epidermoid Rupture by MR Imaging. A Case Report.

Intracranial epidermoids are benign tumours arising from retained ectodermal implants. Spontaneous rupture is an important though rare complication of intracranial epidermoid. To our knowledge, MR findings in spontaneous epidermoid rupture have not been well described to date. We report the case of a 60-year-old man who presented with a two day history of headache, altered sensorium and left hemiplegia. A diagnosis of ruptured epidermoid was made based on MR imaging findings which were subsequently proven by histopathology.