Current clinical features of subarachnoid hemorrhage resulting from anterior communicating artery region aneurysms rupture (literature review)

Background. Aneurysmal subarachnoid hemorrhage (aSAH) accounts for approximately 80% of all SAH cases worldwide and remains a significant cause of mortality and long-term disability, particularly among young and working-aged people. It is known aSAH resulting from the rupture of aneurysms in the anterior communicating artery (AComA) region accounts for about a third of all cases of aSAH and has a range of specific clinical manifestations, affecting various functional systems of the body, which are the focus of this article. Purpose – to analyze and systematize relevant literature sources on the clinical features of aSAH resulting from the rupture of ACoA aneurysms (A-ACoA). Materials and Methods. A systematic review and analysis of scientific literature was carried out using the PubMed, Scopus, and Web of Science databases to explore the clinical features of aSAH resulting from rupture of AComA-A. Combinations of keywords were used to narrow the search query: arterial aneurysm, subarachnoid hemorrhage, anterior communicating artery, clinical features. The sources found were classified by thematic areas, methodological approaches, and chronology. The synthesis of the obtained data was carried out by comparing the results of the studies, which allowed identifying common trends, contradictions, and promising directions for further scientific research. Results. There is increasing evidence that the course of aneurysmal subarachnoid hemorrhage (aSAH) in patients with А-AComA rupture has significant clinical differences compared to ruptures of arterial aneurysms (AAs) in other locations. The rupture of AA in the AComA region is accompanied by specific clinical manifestations, determined not only by the AAʼs location but also by the development of vasospasm and disruption of functional connections between different brain regions that play a crucial role in the emergence of olfactory, visual, oculomotor, motor, and cognitive impairments, which have been described in detail in this article. Conclusion. Assessment of the clinical features of А-AComA rupture is crucial for predicting the course of the acute period of aSAH in this region.