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 guidelines ¹⁾

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.

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