Distal-end aneurysm of the frontopolar artery with an atypical postoperative complication: case report

We present a unique case of a saccular aneurysm originating from the distal end of the right frontopolar artery (FPA). This previously healthy, 54-year-old man had sustained a mild head trauma. On admission, he was lethargic, but his neurological examination results were otherwise normal. Neuroradiological studies (including brain computed tomography, magnetic resonance imaging, and cerebral angiography) demonstrated a distal-end aneurysm of the right FPA. The aneurysm was clipped and resected via a right frontal craniotomy. The postoperative course was uneventful. Pathological examination of the resected specimen confirmed rupture of the wall of a true aneurysm. The patient's medical history was also negative for trauma in the past, previous neurological disease, and vascular collagen disorders. Routine angiography performed 30 days postoperatively demonstrated complete occlusion of the right FPA. The patient was free of focal neurological deficits. This case demonstrates that not all distally located aneurysms are necessarily mycotic or traumatic.