Internal Trapping of a Growing Ruptured Dissecting Aneurysm of the A1 Segment: A Case Report and Literature Review

A 47-year-old man presented with sudden-onset headache and Fisher group 3 subarachnoid hemorrhage. The World Federation of Neurological Surgeons grade was II. Digital subtraction angiography (DSA) only showed a vessel wall irregularity in the A1 segment right anterior cerebral artery (ACA), but an obvious bleeding source not detected. Repeat tiny aneurysmal dilatation intimal flap. aneurysm enlarged on subsequent angiograms. Dissecting diagnosed, patient underwent internal trapping to prevent rerupture. Postoperative DSA complete obliteration dissected segment. Magnetic resonance imaging clinically silent infarction territory perforators. Parent occlusion for can be effective, provided that sufficient collateral blood flow from contralateral ACA is observed. We recommend endovascular this setting hope fellow clinicians select approach rare pathology.