CT Angiographic Evaluation of Anterior Cerebral Artery Aneurysms: A Case Series

Background: Anterior cerebral artery (ACA) aneurysms are among the rare intracranial aneurysms and accounts for small fraction of all the intra cranial aneurysms. These carry a high risk of rupture. Their deep intra hemispheric location and close relationship with the pericallosal–callosomarginal bifurcation often make their identification and characterization challenging on routine imaging. While DSA (digital subtraction Angiography) remains the gold standard for diagnosis the intra cranial aneurysms, CT angiography (CTA) is a non-invasive and rapid modality for their detection and characterization. Objective: Here we report five cases of ACA aneurysms to describe the CT angiography findings in five cases of ACA aneurysms. Materials and Methods: This observational prospective study includes five patients diagnosed with ACA aneurysms on CT angiography within a span of 3 months. These patient presented with acute severe headache and underwent CT Angiography at Department of Radio diagnosis, BKL Walawalkar Rural Medical College, hospital, Chiplun, Ratnagiri, Maharashtra, India. Three patients presented with incidentally detected unruptured aneurysms, while two presented with subarachnoid hemorrhage secondary to aneurysmal rupture. All patients underwent CT angiography on a 32-slice scanner, with multiplanar and three-dimensional volume-rendered reconstructions for detailed morphologic assessment. Results: Three unruptured aneurysms were indentified, saccular in configuration, arising from the ACA and the ACoM, while the other two cases demonstrated a ruptured aneurysm with subarachnoid hemorrhage along the interhemispheric fissure. Conclusion: ACA aneurysms, although rare, can be confidently diagnosed on CT angiography. Recognizing their characteristic imaging features and anatomical relationships is essential for early detection, differentiation of ruptured from incidental lesions, and guiding therapeutic planning.