Infra-optic Course of Both Anterior Cerebral Arteries Associated with a Middle Cerebral Artery Aneurysm and an Aortic Coarctation

cating artery was first described by Robinson and demonstrated on angiography by Isherwood and Dutton, 44 cases have been reported (1, 2). Most cases demonstrate unilateral involvement and only 10 cases of bilateral involvement have been reported out of the 45 cases, including the case described in this report. Although cerebral aneurysms are frequently associated with this congenital anomaly, an infra-optic course of the anterior cerebral artery (ACA) and association with aortic coarctation is rare (3). To the best of our knowledge, this is the third case documented for an association with aortic coarctation in a patient an infra-optic course of the ACA (2, 4). We report a case of bilateral infra-optic ACAs where a middle cerebral artery aneurysm and aortic coarctation are associated. The significance of recognition of this anomaly for patient management is discussed.