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Chowdhury et al. Neuroimmunol Neuroinflammation 2018;5:39 Neuroimmunology and
DOI: 10.20517/2347-8659.2018.37 Neuroinflammation

Letter to Editor Open Access

Azygos anterior cerebral artery aneurysm with
subarachnoid hemorrhage

Dhiman Chowdhury, Nazmin Ahmed, Bipin Chaurasia, Kanak Kanti Barua

Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka 1000, Bangladesh.
Correspondence to: Dr. Bipin Chaurasia, Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka 1000,
Bangladesh. E-mail: trozexa@gmail.com
How to cite this article: Chowdhury D, Ahmed N, Chaurasia B, Barua KK. Azygos anterior cerebral artery aneurysm with
subarachnoid hemorrhage. Neuroimmunol Neuroinflammation 2018;5:39. http://dx.doi.org/10.20517/2347-8659.2018.37

Received: 8 Jun 2018 First Decision: 10 Aug 2018 Revised: 10 Aug 2018 Accepted: 13 Aug 2018 Published: 28 Sep 2018

Science Editor: Athanassios P. Kyritsis Copy Editor: Yuan-Li Wang Production Editor: Zhong-Yu Guo

Azygos anterior cerebral artery (ACA) is type I variation of ACA with a reported incidence of < 1% in
[1]
population . This variation predisposes to the formation of aneurysm especially at the bifurcation zone.
The aneurysm develops because of double hemodynamic pressure supplying medial surface of both cerebral
hemispheres.

[2,3]
However reported incidence of saccular aneurysm in azygos ACA is between 13% and 71% . It is often
associated with other central nervous system (CNS) malformations like agenesis of corpus callosum,
[4]
hydranencephaly and other vascular malformations .

In this paper we report a patient who presented with subarachnoid hemorrhage. Later on we did three
dimensional (3D) computed tomography (CT) image. She was then diagnosed as a case of azygos ACA
aneurysm.

A 50-year-old female presented with a history of sudden onset of severe headache followed by transient loss
of consciousness. There was no previous history of hypertension and diabetes mellitus. During admission
she had mild dull aching headache and neck rigidity. There was no focal neurological deficit (Hunt and Hess
grade-I).

Four hours after the incident, CT scan of brain revealed subarachnoid hemorrhage in the basal cistern and
hematoma in the interhemispheric fissure [Figure 1] which was Fisher CT scan grade 3. After 7 days of the
incident repeat CT scan of brain was done which showed diminution of the size of hematoma [Figure 2]. At

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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