Endovascular treatment of fusiform A2 aneurysm with parent artery occlusion

BACKGROUND: A2 aneurysms are rare with a reported incidence of <1% of the intracranial aneurysms. These aneurysms are located between the anterior communicating artery and genu of the corpus callosum. Fusiform aneurysms in this location are even rarer and we present one such case of fusiform A2 aneurysm treated with endovascular technique. CASE DESCRIPTION: In this report, we present a case of ruptured fusiform A2 or proximal pericallosal artery aneurysm in a middle-aged female who presented with subarachnoid hemorrhage. She subsequently underwent endovascular parent artery occlusion, and post-procedure angiogram showed good pial collaterals filling the distal territory. She developed transient lower limb weakness which improved over the next 24 h with supportive inotrope management to maintain adequate cerebral flow. CONCLUSION: We report a rare unique case of ruptured fusiform proximal pericallosal artery aneurysm. Endovascular treatment of this type of aneurysm is a feasible method and can be considered as an effective alternative to surgical technique.