{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T16:00:25Z","timestamp":1765382425038},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T00:00:00Z","timestamp":1680220800000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Anatomical variations often occur in the anterior communicating artery (AComA) complex, and a careful preoperative evaluation is required before repair of this lesion. We report a case of a fenestrated AComA complex mimicking an unruptured cerebral aneurysm. A 49-year-old woman was referred to our hospital under suspicion of unruptured aneurysms of the AComA and the left middle cerebral artery on magnetic resonance angiography (MRA). Additional three-dimensional computed tomographic angiography (CTA) showed the lesion arising from the AComA complex with a maximum diameter of 4.2\u2009mm. Intraoperative findings showed that the putative aneurysm was actually a fenestrated AComA complex as the blood vessels that formed the AComA complex were dilated and meandering. After the operation, MRA and CTA three-dimensional images were reviewed again but we could still not diagnose the lesion as a fenestrated AComA complex rather than an aneurysm. However, in the MRA source image, a secant line in the lesion was the only finding suggestive of a fenestration. The AComA complex is often associated with various vascular malformations, and it is essential to consider this association in the preoperative evaluation. The interpretation of source images may be helpful for accurate diagnosis and surgical planning.<\/jats:p>","DOI":"10.1055\/s-0043-1764119","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T23:15:07Z","timestamp":1680304507000},"page":"201-205","source":"Crossref","is-referenced-by-count":6,"title":["Fenestrated Anterior Communicating Artery Complex Mimicking an Unruptured Aneurysm: Diagnostic Pitfall"],"prefix":"10.1055","volume":"18","author":[{"given":"Atsushi","family":"Tsukada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Kaname, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyoyuki","family":"Yanaka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Kaname, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hayato","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Kaname, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuniyuki","family":"Onuma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Kaname, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya","family":"Takada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Kaname, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiro","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Kaname, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiichi","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,3,31]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"E20","DOI":"10.3171\/2019.9.FOCUS19653","article-title":"Comprehensive review of imaging of intracranial aneurysms and angiographically negative subarachnoid hemorrhage","volume":"47","author":"B M Howard","year":"2019","journal-title":"Neurosurg Focus"},{"key":"ref2","first-page":"672","article-title":"Usefulness of the low tube voltage scan in the head CT-angiography with the subarachnoid hemorrhage","volume":"21","author":"K Tsunou","year":"2018","journal-title":"Journal of Japanese Society for Emergency Medicine."},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s00234-015-1610-9","article-title":"Morphological risk factors for the rupture of anterior communicating artery aneurysms: the significance of fenestration","volume":"58","author":"J H Choi","year":"2016","journal-title":"Neuroradiology"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"261","DOI":"10.15274\/INR-2014-10027","article-title":"Cerebral arterial fenestrations","volume":"20","author":"D L Cooke","year":"2014","journal-title":"Interv Neuroradiol"},{"key":"ref5","first-page":"105","volume-title":"Diagnostic Cerebral Angiography. 2nd ed","author":"A G Osborn","year":"1999"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.jocn.2020.08.019","article-title":"Anatomical variants of anterior communicating artery complex. 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