An Official publication of The Asian Congress of Neurological Surgeons (AsianCNS)

Search Article
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Advertise Subscribe Contacts Login  Facebook Tweeter
  Users Online: 125 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  
Ahead of Print

Surgical significance of infra-optic course of A1 segment of anterior cerebral artery: Report of two cases

1 Department of Neurosurgery, Saveetha Medical College, Chennai, Tamil Nadu, India
2 Department of Neurosurgery, Apollo Speciality Hospitals, Chennai, Tamil Nadu, India

Correspondence Address:
HS Nandish,
Department of Neurosurgery, Saveetha Medical College, Thandalam, Chennai - 600 124, Tamil Nadu
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_34_19

Anatomic variations of the anterior cerebral artery-anterior communicating artery complex (ACA-AComA) are common. An infra-optic course of the A1-ACA is extremely rare, and recognition of this variant is very important in planning surgery for ACA-AComA complex aneurysms. We present two cases of spontaneous subarachnoid hemorrhage due to ruptured AComA aneurysms with unilateral infra-optic course of the A1-ACA. In both the cases, the preoperative catheter angiography revealed low bifurcation with a horizontal course of internal carotid artery. In our first case, the finding was rather unexpected; however, in our second case, we could anticipate an infra-optic course of A1-ACA. Preoperative recognition of this anomaly helps in achieving proximal vascular control with ease and confidence. It also enhances surgical safety of aneurysm clipping, by avoiding unnecessary dissection elsewhere. This emphasizes the importance of careful preoperative angiographic evaluation. In the presence of this anomaly, one should always search for other associated vascular anomalies.

Print this article
  Search Pubmed for
    -  Nandish H S
    -  Selvapandian S
    -  Ghosh S
 Citation Manager
 Article Access Statistics
 Reader Comments
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded4    

Recommend this journal