Surgery of Anterior Communicating Artery Aneurysms

Anterior communicating artery (AComA) aneurysms are among the most common aneurysms in different case series. They compose 36 of 175 cases (20.6%) in our latest case series of unruptured aneurysms coming second only after middle cerebral artery aneurysms (69 cases) [1]. In case series of ruptured aneurysms, the incidence is higher, and around 30–40% of all intracranial aneurysms are located in the AcomA region. Their presentation with subarachnoid hemorrhage (SAH) is not essentially different from other aneurysms and will not be repeated in this chapter again. Here, we do not intend to make an exhaustive review of different aspects of medical, interventional, or surgical management of these aneurysms. Instead, we will explain the most important pre-, intra-, and postoperative aspects observed in our institute.