Bilateral infraoptic anterior cerebral artery associated with de novo aneurysm formation over a 10-year period: illustrative case
Recommended Citation
Alexander H, Alsalahi AH, Claus CF. Bilateral infraoptic anterior cerebral artery associated with de novo aneurysm formation over a 10-year period: illustrative case. J Neurosurg Case Lessons 2025; 10(25).
Document Type
Article
Publication Date
12-22-2025
Publication Title
J Neurosurg Case Lessons
Keywords
carotid–anterior cerebral artery anastomosis; infrachiasmatic anterior cerebral artery; infraoptic anterior cerebral artery
Abstract
BACKGROUND: The infraoptic origin of the anterior cerebral artery (ACA) is a rare anatomical variant with implications for endovascular and microsurgical intervention. To date, there have been approximately 55 reported cases in the literature. Of these, only 20 are bilateral. The authors present the case of a 55-year-old female with bilateral infraoptic origin of the ACA with an associated aneurysm that developed over the course of 10 years.
OBSERVATIONS: On cerebral angiography, the bilateral ACAs originated from the cavernous/ophthalmic segment of the internal cerebral artery. The A1 segment was hypoplastic on both sides. The right infraoptic ACA was associated with an aneurysm, while the left had an infundibulum.
LESSONS: Patients with infraoptic ACA may be at risk for developing aneurysms de novo due to turbulent flow from the morphological changes to the vessel and therefore should be considered for interval follow-up with serial imaging. Additionally, preoperative recognition of this variant is critical in order to understand the aberrant anatomy and avoid any inadvertent vascular complications. https://thejns.org/doi/10.3171/CASE25676.
PubMed ID
41569785
Volume
10
Issue
25
