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KMID : 1005420230250030340
Journal of Cerebrovascular and Endovascular Neurosurgery
2023 Volume.25 No. 3 p.340 ~ p.346
Ruptured mirror DACA aneurysm: A rare case report and review of literature
Deepak Kumar Singh

Prevesh Kumar Sharma
Arun Kumar Singh
Vipin Kumar Chand
Abstract
Bilateral distal anterior cerebral artery (DACA) aneurysms also called ¡°kissing aneurysms¡± or ¡°mirror aneurysm¡± are extremely rare, accounting for only 0.2% of all intracranial aneurysms. There have only been a few examples of mirror DACA aneurysms reported in the literature. Here, we report a rare case of mirror DACA aneurysm in a middle aged female with its successful clipping. Patient was admitted with severe headache and altered sensorium. Computed tomography (CT) head was suggestive of anterior inter-hemispheric hematoma. Digital subtraction angiography (DSA) was done which was suggestive of two distal anterior cerebral artery aneurysms located at same anatomical position. It was treated through microsurgical clipping. Mirror image DACA aneurysms are rare occurrence. All patients with ruptured DACA aneurysms should have angiography with 3D reconstruction studies. This aids in determining the aneurysm¡¯s morphology and planning treatment accordingly.
KEYWORD
Distal anterior cerebral artery, Aneurysm, Clipping, Coiling, Inter-hemispheric hematoma
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