Injuries of the Cingulum and Fornix After Rupture of an Anterior Communicating Artery Aneurysm: A Diffusion Tensor Tractography Study

BACKGROUND: After rupture of an anterior communicating artery (ACoA) aneurysm, the anterior cingulum and the fornix can be vulnerable to injury. However, very little is known about this topic. OBJECTIVE: To investigate injuries of the cingulum and fornix in patients with an ACoA aneurysm rupture with diffusion tensor tractography. METHODS: Eleven consecutive patients with an ACoA aneurysm rupture and 11 age- and sex-matched normal control subjects were recruited. Diffusion tensor imaging was scanned at an average of 54.1 days (range, 29-97 days) after onset of ACoA aneurysm rupture. RESULTS: We found that 6 (54.5%) and 7 (63.6%) of 11 patients revealed no trajectory of the anterior cingulum and the fornical body on diffusion tensor tractography, respectively. In terms of diffusion tensor imaging parameters, we found that the fractional anisotropy value and tract volume of the cingulum and fornix were decreased (P < .05) and that mean diffusivity values were increased (P < .05), except for those of the left fornix, which showed no difference (P > .05). CONCLUSION: We found injuries of the cingulum and fornix in patients with an ACoA aneurysm rupture. It is our belief that sustained memory impairment of patients with an ACoA aneurysm rupture might be related to injury of the cingulum and fornix. Therefore, we recommend evaluation of the cingulum and fornix with diffusion tensor tractography for patients with an ACoA aneurysm rupture.