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Updated: Sep 28, 2025

Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
An anomalous hyperplastic anterior choroidal artery associated with an unruptured internal carotid-posterior
Akio Nishino1, Kousuke Mori2, Yoshihiro Yano3
1Department of Neurosurgery, Kinki Central Hospital, 3-1 Kurumazuka, Itami-city, Hyogo 664-8533, Japan.
Abstract:
The anterior choroidal artery (AChA) injuries can result in severe neurologic deficits, so requiring careful observation to avoid inadvertent damage during neuroendovascular procedures. In this case report, we present the unusual case of an anomalous hyperplastic AChA associated with a fetal-type posterior communicating artery (PCoA), and an unruptured internal carotid artery (ICA) -PCoA aneurysm. A 54-year-old woman presented with persistent headache. Brain magnetic resonance imaging (MRI) showed an unruptured cerebral aneurysm in the right ICA, and cerebral angiography revealed a proximal fetal-type PComA and a distal anomalous hyperplastic AChA. Coil embolization was performed with no neurologic deficits and the target lesion was embolized with a total of 6 coils. An anomalous hyperplastic AchA has a lengthy course with numerous choroidal and perforating branches, and therefore, an abundant perfusion region. Thorough knowledge of the development and anatomy of anomalous arteries is important for safely performing endovascular procedures without causing any ischemic complications.
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