Azygos Anterior t'erebrat Artery Aneurysm

Abstract

Two cases of azygos anterior cerebral artery aneurysm are reported. Case 1 was a 53-year-old male. He had an attack of left hemiparesis two months before admission. An enhanced computerized tomography (CT) scan demonstrated a ring enhancement in the right frontal lobe adjacent to the falx. An azygos anterior cerebral artery was visualized on the right and left carotid angiograms. The aneurysm was situated at the distal end of the azygos artery. The azygos artery was confirmed at the operation and the aneurysmal neck was wrapped without any serious deficit. Case 2 was a 60year-old male. He was suddenly seized with a headache and soon became unconscious. He was immediately hospitalized and a CT scan demonstrated a subarachnoid hemorrhage. The left carotid angiography with contralateral compression revealed an azygos artery and an aneurysm in its proximal portion. The azygos artery was confirmed at the operation and the aneurysmal neck was wrapped. After the operation, however, he developed mutism, paresis of the lower extremities and urinary incontinence. Frequent association of the azygos artery with aneurysm may suggest congenital factors in the development of cerebral aneurysms. From an anatomical point of view, circulatory disturbances followed by brain damage may develop in bilateral cerebral hemispheres by clipping the azygos anterior cerebral artery aneurysm. Therefore, care should be taken to avoid such a risk in operations.