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Updated: Mar 30, 2026

Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Accessory middle cerebral artery associated with an unruptured aneurysm at its origin
Motohiro Nomura1, Akira Tamase1, Tomoya Kamide1
1Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, 132 Katsura-cho, Sakae-ku, Yokohama 247-8581, Japan.
Background:
An aneurysm originating from the junction of the A1 segment of the anterior cerebral artery and accessory middle cerebral artery (Acc-MCA) is markedly rare. We report a rare case of an Acc-MCA aneurysm, and discuss the clinical course and management of this rare condition.
Case Description:
A 64-year-old man with a past history of cerebral infarction was revealed to have a left Acc-MCA and an aneurysm at its origin. The aneurysm was clipped via a transsylvian approach. Due to its location and projectile direction, the neck of the aneurysm was left partially unclipped.
Conclusion:
Although an Acc-MCA aneurysm is very rare, it has a potential risk of rupture. Therefore, radical treatment is necessary for such aneurysms.
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