Topography-anatomical characteristics and the choice of surgical access to aneurysms of distal segments of the anterior cerebral artery
Anatomical and topographical features of arterial aneurysms (AA) of distal segment of the anterior cerebral artery (ACA) were analyzed and the optimal surgical access to AA of such localization was determined.A retrospective analysis of case histories of 42 patients who were treated at A.P. Romodanov Institute of Neurosurgery with AA of distal segments of ACA for the period from 1998 to 2010 was held.After analyzing the results of clinical and instrumental examination of 42 patients we have found the following structure of AA of distal segments of ACA localization: А2 segment in 5 patients, А3 in 33 patients, callosomarginal artery in 2 patients and А4-А5 segments in 2 patients.Among AA of distal segments of ACA the most common AA in А3 segment, especially in a discharge of callosomarginal artery from ACA.The most appropriate conditions for AA of distal segments of ACA clipping could be provided from two accesses: subfrontal pterional and parasagittal interhemispheric.