Parent Artery Occlusion for Subarachnoid Hemorrhage due to Right Frontopolar Artery Dissection: A Case Report.

Abstract

Objective: We report a case of subarachnoid hemorrhage (SAH) due to the ruptured dissection aneurysm of the frontopolar artery (FPA), which was successfully treated with parent artery occlusion (PAO).

Case presentation: A 42-year-old woman was brought to our hospital suffering from sudden severe headache and vomiting. Four days prior to admission, she experienced a mild frontal headache. Head computed tomography (CT) revealed SAH with a right medial frontal lobe hematoma. On the day of admission, we performed cerebral angiography, and a fusiform aneurysm was found in the FPA branching from the proximal right anterior cerebral artery (A1), which was suspected to be the dissection. We performed PAO for the right FPA. The patient was discharged with mRS:0 on the 27th day of admission. Several reports describe that the FPA usually bifurcate from the A2 segment, and it is rarely dissected. However, in our case, the FPA originated from the distal part of the A1 segment, and the dissection aneurysm of FPA ruptured.

Conclusion: To the best of our knowledge, this is the first reported case of SAH due to a ruptured dissection aneurysm of FPA treated by PAO.