Anterior communicating artery aneurysm is the most common form of intracranial aneurysm. We present a rare case of a rare case of internal carotid occlusion with anterior communicating aneurysm of a 33 years male patient. The male patient presented with sudden severe headache with transient visual loss in right eye and double vision with squint on right eye for 26 days. All the symptoms subsided within 12 days except headache which persists till to date. On neurological examination patients higher psychic function was normal. Cranial nerves were intact, Optic disc- Pailloedema on both sides. In the investigations, CT scan of brain revealed subarachnoid hemorrhage. CT angiogram of brain showed subtotal occlusion in extra and intracranial part of right internal carotid artery with a small aneurysm in anterior communicating artery (2.2 x2.18 mm). The period of 14 days, the CT angiogram of brain revealed the same radiological findings. Some EC-IC collaterals through petrosquamous artery were found to middle cerebral artery on right. Arteriographic evaluation of the anterior communicating artery region is necessary so that preexisting aneurysms may be documented and treated.

Keywords: Anterior communicating artery aneurysm, Optic disc- Pailloedema, CT scan, Arteriographic evaluation.

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Dr Md Moshiur Rahman

Assistant Professor (current charge), Neurosurgery Department, HFRCMC, Dhaka, Bangladesh