Anterior Ethmoidal Artery Aneurysm and Intracerebral Hemorrhage
L.B. da Costaa,b,
T. Valianteb,
K. TerBruggec and
M. Tymianskib
a Division of Neurosurgery, Benjamin Guimaraes Foundation/Hospital da Baleia, Belo Horizonte, Brazil
b Division of Neurosurgery, Toronto Western Hospital, Toronto, Ontario, Canada
c Department of Radiology, University of Toronto, Toronto, Ontario, Canada
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Fig. 1. CT showing the hemorrhage in the right gyrus rectus.
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Fig. 2. AngioMRI showing the occluded right internal carotid artery and the presence of an aneurysmal dilation in the anterior cranial fossa (arrows).
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Fig. 3. Left intracranial carotid artery angiogram, showing the contralateral blood supply to the right hemisphere, and the deep collaterals supplying the right hemisphere (A) and left vertebral angiogram showing the contribution of the posterior circulation to the blood supply in the supratentorial circulation (B).
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Fig. 4. Preoperative angiogram showing the small aneurysmal dilation related to a branch of the right anterior ethmoidal artery. The aneurysm is much bigger than the parent vessel, making it difficult to define the neck size. After the removal of the aneurysm the very small branch proceeded to the inferior aspect of the frontal lobe, as also seen during the surgery (A). Postoperative angiogram of the right external carotid artery showing the exclusion of the aneurysm (arrow). Preservation of the parent branch was not possible, because of its small size in relation with the aneurysm, but the branch of the anterior ethmoidal artery thought to be responsible for some supply to the right eye was preserved (arrowhead, B).
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