Ruptured anterior communicating artery aneurysm associated with anterior cranial fossa dural arteriovenous fistula--case report

Neurol Med Chir (Tokyo). 2011;51(1):40-4. doi: 10.2176/nmc.51.40.


A 77-year-old man presented with an extremely rare association of anterior cranial fossa dural arteriovenous fistula (AVF) with anterior communicating artery (ACoA) aneurysm manifesting as consciousness deterioration due to intracerebral hemorrhage in the left frontal lobe and diffuse subarachnoid hemorrhage. Angiography confirmed the association of a dural AVF fed by both ethmoidal arteries and an ACoA aneurysm. Surgery for these two lesions was performed concurrently, and the ACoA aneurysm was found to be responsible for the hemorrhage. This association seems incidental, but is clinically significant since the preoperative determination of the bleeding point is difficult. We conclude that these two lesions should be treated simultaneously, to avoid leaving the ruptured point untreated.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Central Nervous System Vascular Malformations / diagnostic imaging*
  • Central Nervous System Vascular Malformations / surgery
  • Cerebral Angiography*
  • Cerebral Hemorrhage / diagnostic imaging*
  • Cerebral Hemorrhage / surgery
  • Combined Modality Therapy
  • Cranial Fossa, Anterior / blood supply*
  • Craniotomy / methods
  • Diagnosis, Differential
  • Dominance, Cerebral / physiology
  • Headache / etiology
  • Humans
  • Image Processing, Computer-Assisted*
  • Imaging, Three-Dimensional*
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / surgery
  • Male
  • Subarachnoid Hemorrhage / diagnostic imaging*
  • Subarachnoid Hemorrhage / surgery
  • Surgical Instruments
  • Tomography, X-Ray Computed*
  • Unconsciousness / etiology