A ruptured aneurysm arising from the total duplication of the posterior communicating artery

Abstract

A 36-year-old male suffered from a sudden headache. Computed tomography (CT) showed a subarachnoid hemorrhage (SAH). CT angiography demonstrated an aneurysm arising from the duplicate origin of the right posterior communicating artery (PcomA). The aneurysm was at the junction of the internal carotid artery and the distal branch of the PcomA duplication. Frontotemporal craniotomy and neck clipping were performed for the ruptured aneurysm. The patient’s post-operative course was uneventful and without symptomatic vasospasm. Post-operative angiography revealed the total duplication of the PcomA. The ophthalmic artery originating from cavernous portion anomalously. Although the relationship between the frequency of aneurysms and PcomA duplication is unclear, the PcomA duplication-in addition to the ophthalmic artery's anomalous origin-was speculated to be an anomaly related to the developmental processes of cerebral arteries.

Keywords

• Posterior communicating artery
• Aneurysm
• Duplication