{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:28:27Z","timestamp":1780579707492,"version":"3.54.1"},"reference-count":41,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Aneurysms of the A1 segment of the anterior cerebral artery (ACA) are rare and have characteristics differentiating them from other intracranial aneurysms. Their microsurgical management is challenging and requires different strategies. In this article, we review the surgical anatomy of the A1 segment of the ACA with cadaveric dissections and describe the microsurgical management of complex A1 aneurysms with illustrative cases.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>A right pterional craniotomy and Sylvian dissection were performed on a formalin-fixed and silicone-injected cadaver head to depict the key anatomic structures and surgical corridors for microsurgical clipping of A1 segment aneurysms. The microneurosurgical management of ruptured and unruptured aneurysms of the A1 segment of the ACA is described with case illustrations.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>The A1 segment of the ACA can be subdivided into proximal, middle, and distal subsegments, the former having abundant perforating branches. Both patients treated with microsurgical clipping had excellent and durable outcomes and postoperative cerebral angiograms showed complete aneurysm occlusion.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Small A1 aneurysms may require early treatment as their rupture risk appears to be higher. A1 aneurysms are usually embedded in perforators, especially those arising from the proximal A1 subsegment, and require careful distal to proximal microdissection and strategic placement of the aneurysm clip blades. The approach, arachnoid dissection, and angles of attack are carefully planned after accounting for the aneurysm dome projection, precise location of the aneurysm neck and perforators, and the presence or absence of subarachnoid hemorrhage.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_68_2022","type":"journal-article","created":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T08:54:39Z","timestamp":1658480079000},"page":"310","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Microneurosurgical management of aneurysms of the A1 segment of the anterior cerebral artery: Anatomy and surgical technique"],"prefix":"10.25259","volume":"13","author":[{"given":"Alvaro","family":"Campero","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, LINT, Facultad de Medicina, Universidad Nacional de Tucum\u00e1n,"},{"name":"Department of Neurological Surgery, Hospital Padilla, Tucum\u00e1n, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mat\u00edas","family":"Baldoncini","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Hospital San Fernando, Argentina"},{"name":"Laboratory of Microsurgical Neuroanatomy, Second Chair of Gross Anatomy, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan F.","family":"Villalonga","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, LINT, Facultad de Medicina, Universidad Nacional de Tucum\u00e1n,"},{"name":"Department of Neurological Surgery, Hospital Padilla, Tucum\u00e1n, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice Giotta","family":"Lucifero","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabino","family":"Luzzi","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy."},{"name":"Neurosurgery Unit, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2022,7,22]]},"reference":[{"key":"10.25259\/SNI_68_2022\/ref-1","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1177\/197140091202500506","article-title":"Endovascular treatment of A1 aneurysms. 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