Giant aneurysm of the proximal anterior cerebral artery

BACKGROUND Giant aneurysms originating from the proximal anterior cerebral artery (Al) are extremely rare. Only 12 cases have been reported previously. CASE REPORT A case of a giant Al aneurysm, which occurred in a patient with a progressive visual loss, is presented. The previous 12 cases are reviewed and discussed. This patient was treated by trapping and decompression of the aneurysm. These aneurysms bleed very rarely; they usually present with signs and symptoms secondary to the mass effect, including visual loss and progressive dementia. Most of these aneurysms have been treated by direct trapping of the aneurysm or by occlusion of the proximal anterior cerebral artery. CONCLUSIONS In most cases, trapping and decompression of the aneurysm is the treatment of choice, since they involve a long segment of the Al that does not allow preservation of the parent artery if direct clipping is performed. (C) 1996 by Elsevier Science Inc.