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Updated: Nov 11, 2025

Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
A1 Segment Unruptured Aneurysm of Persistent Primitive Olfactory Artery Coexisted with Accessory Middle Cerebral
Yuka Ogawa1, Kosuke Soejima1, Ichiro Kawahara1
1Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara Omura-city, Nagasaki 856-8562, Japan.
Abstract:
A persistent primitive olfactory artery (PPOA) is a rare anomaly of anterior cerebral artery (ACA), which generally arises from the internal carotid artery (ICA), runs along the olfactory tract, and makes a hairpin bend to supply the territory of the distal ACA. PPOA is also associated with cerebral aneurysms. An accessory MCA is a variant of the middle cerebral artery (MCA) that arises from either the proximal or distal portion of the A1 segment of the ACA, which runs parallel to the course of the MCA and supplies some of the MCA territory. We experienced a rare case of coexistence of PPOA with an unruptured aneurysm and accessory MCA. Three-dimensional computed tomographic angiography (3D-CTA) has an excellent picture of the spatial relationship of the surrounding bony and vascular structure.
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