Anterior cerebral artery dissection [Neurosurgery Wiki]

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====== Anterior cerebral artery dissection ======

In a single-[[patient]] [[case report]]  
Fuentes et al.  
from The Medical City, Pasig City  
published in [[Cureus]]  
to [[report]] a rare case of [[subarachnoid hemorrhage]] (SAH) from a ruptured [[pseudoaneurysm]] secondary to anterior cerebral artery (ACA-A1 segment) [[dissection]], and its successful treatment with [[stent-assisted coiling]].  
The authors document a favorable outcome following [[endovascular treatment]] of a rare ACA-A1 dissection-induced pseudoaneurysm, arguing for its consideration in similar cases despite the absence of clear [[guideline]]s
((Fuentes DNL, Mercado CMC, Villavicencio J, Mariano MM. [[Subarachnoid Hemorrhage]] From [[Ruptured Pseudoaneurysm]] Secondary to [[Dissection]] of the [[Anterior Cerebral Artery]]: A [[Case Report]]. [[Cureus]]. [[2025]] Jun 3;17(6):e85275. doi: 10.7759/cureus.85275. PMID: 40612842; PMCID: PMC12224219.))

==== Critical Review ====

This case report contributes to the sparse [[literature]] on anterior cerebral artery dissections—particularly in the A1 segment—and their [[endovascular]] management. However, while the case is clinically relevant, the article offers limited scientific depth.

- **Methodology & Rigor:** The study is anecdotal by nature, limited to a single patient without follow-up beyond clinical recovery. No advanced imaging follow-up (e.g., DSA post-treatment surveillance) or long-term outcome data are provided.

- **Literature Integration:** The background is superficially reviewed, lacking detailed [[discussion]] of alternative management strategies or prior similar cases for context.

- **Educational Value:** The report could have enhanced its utility by discussing decision-making rationale (e.g., why stent-assisted coiling over trapping or parent vessel sacrifice) or presenting a flowchart for clinical guidance in such rare cases.

- **Figures & Documentation:** Assuming standard Cureus formatting, the images likely support diagnosis and intervention but are not discussed in the abstract or citation—reducing evaluative scope here.

==== Final Verdict ====

**Takeaway for Neurosurgeons:** 

ACA dissections, though rare, can present with SAH and [[pseudoaneurysm]] formation; endovascular stent-assisted coiling is a viable treatment when feasible. However, lacking long-term data, this should not yet influence standard protocols.

**Bottom Line:** 

A rare, interesting case with a successful outcome, but scientific contribution remains modest due to limited analysis and scope.

**Rating:** **2.5 / 10**

**Publication Date:** June 3, 2025