Mirror image distal anterior cerebral artery aneurysms treated with coil embolization. a report of two cases and literature review.

Mirror image aneurysms of the distal anterior cerebral arteries (DACA) are rare. To the best of our knowledge this is the first case report of two patients with mirror image DACA aneurysms treated successfully with coil embolization. The association of aneurysms with anatomic variants has been extensively reported. We may speculate that the remnants of the failed regression of the supreme anterior communicating artery could lead to an increase in stress across their territorial bifurcation, leading to the development of mirror image DACA aneurysms. We found the endovascular treatment of mirror image DACA aneurysms to be feasible and effective. If possible, we suggest the treatment of both aneurysms in one procedure.

Sacral meningocele and rectal fistula associated with pneumorrhachis and pneumocephalus. A case report and literature review.

Pneumorrhachis (PR), the presence of air in the spinal canal, is a rare but suggestive radiographic finding, associated to different aetiologies and possible pathways of air entry into the spinal canal. It can be divided into primary and secondary PR, descriptively classified into extra- or intradural PR and aetiologically subsumed into iatrogenic, traumatic and non traumatic PR. Pneumoencephalus (PE), lack of air in the skull, is the equivalent intracranial phenomenon, associated mostly with traumatic or iatrogenic aetiology. Non traumatic PR and PE, especially when concurrent, are an uncommon radiological finding.

Sylvian subarachnoid and extra-pial cavernous angioma.

Cavernous angiomas are one of the four types of vascular malformations of the central nervous system. Lesions situated subarachnoidally are rare although some cases with an infratentorial localization have been reported. Our case represents an unusual localization of a subarachnoid cavernous angioma. A 35- year-old patient was admitted to our department with signs of subarachnoid hemorrhage. A 1 cm hyperdense lesion placed at the right Sylvian fissure was distinguished by CT-scan examination and no arterial supply was revealed on cerebral angiography. Surgical intervention showed a lesion placed extra-pial and totally encased in the subarachnoid space in the superficial part of the Sylvian cistern. This case represents a radiologically visible supratentorial extra-pial subarachnoidal cavernous angioma. This case provides confirmation of one of the supposed causes of subarachnoid hemorrahage ''sine materia''.

[Aneurysm of the terminal part of the lenticulostriate artery]. / L'anévrysme de la portion terminale de l'artère lenticulostriée.

A case of aneurysm of the lenticulostriate artery localized at its terminal portion is reported. This peculiar site of origin has not been noted by others and implies any other unusual cause and localisation.

"Cross-over" duplication of middle cerebral artery, agenesis of internal carotid artery and saccular aneurysms.

The authors describe a patient with anomalous branches of the left internal carotid artery, "cross-over" duplication of its middle cerebral artery and agenesis of the contra-lateral internal carotid artery associated with two aneurysms successfully clipped. Pertinent literature is reviewed.