Surgical Repair of Lacerated Anterior Cerebral Artery Presented With Massive XXXX .

@entity1 @entity548 @entity510 @entity772 @entity4551 @entity439 @entity1410 @entity1779 @entity2849 @entity438
OBJECTIVE AND IMPORTANCE: Traumatic @entity438 present diagnostic and therapeutic challenges. Owing to their fragile nature, endovascular intervention has become the first-line treatment; however, direct surgery has an advantage in certain cases. CLINICAL PRESENTATION: A 34-year-old @entity1 in @entity772 was admitted after a motor vehicle accident. Brain computed tomographic scans revealed deep bifrontal, left intraventricular, and @entity510 . Three-dimensional computed tomographic angiography and digital subtraction angiography revealed an @entity439 arising from the left pericallosal artery. INTERVENTION: A massive @entity1779 prompted us to perform emergency surgical intervention. We immediately removed the @entity1410 and extirpated the @entity439 . After @entity1410 evacuation via the interhemispheric approach, a pulsating red sphere projecting from the pericallosal artery, with no obvious solid wall or neck, was encountered. While retracting the frontal lobe, it suddenly ruptured. Under temporary trapping of the parent artery, the point of @entity548 was identified. No @entity439 wall or fibrous tissue was present, whereas a 1.5-mm laceration was observed at the pericallosal artery close to its branching point. The laceration was sutured with 10-0 nylon. Postoperative digital subtraction angiography confirmed patency of the pericallosal artery. CONCLUSIONS: Although recent technologic advances of intravascular surgery have enabled successful treatment of @entity2849 , open surgical intervention still has some advantages of providing definitive hemostasis, allowing for parent artery reconstruction, and facilitating mass reduction. The case in the current study was quite unusual in that angiographic @entity439 had disrupted easily, leaving @entity4551 . This finding implies the probability of unavoidable parent artery occlusion when endovascular treatment is applied.
