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FIG 4. Patient with a left internal carotid artery aneurysm.
A, 3D-CTA (superior view) shows the left DMCV (arrow) emptying into the SPS and poor BVR development on the left side compared with that on the right side (double arrows).
B, 3D-CTA (left anterior view) reveals that the anterior cerebral vein (black arrow) and DMCV (double white arrows) join and empty into the SPS (white arrow). 3D-CTA also shows these veins in front of a left internal carotid artery aneurysm (*) but not in contact with it. C indicates the proximal portion of the left internal carotid artery.
C, A microscopic operative view shows that the left frontal lobe and the left temporal lobe are retracted to expose the left internal carotid artery aneurysm (*). A black arrow indicates the proximal portion of the left internal carotid artery. The connecting vein (white arrow) depicted in B was smoothly detached from the aneurysm and the internal carotid artery, but application of the clip was disturbed by this vein.
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