A completely thrombosed, nongiant middle cerebral artery aneurysm mimicking an intra-axial neoplasm

Nguyen, Ha Son; Doan, Ninh; Eckardt, Gerald; Gelsomino, Michael; Shabani, Saman; Brown, W.G. Scott; Mueller, Wade; Pollock, Glen

doi:10.4103/2152-7806.164696

Cited by 13 publications

(8 citation statements)

References 23 publications

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“…When thrombosis occurs, imaging findings can mimic intra-axial neoplasms and patients may undergo oncologic workup with attempted resection of the lesion. 8…”

Section: Discussionmentioning

confidence: 99%

Disappearance of a small unruptured intracranial aneurysm: A case report and brief literature review

et al. 2023

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Disappearing intracranial aneurysms are rare and have not been extensively reported in the literature. They are often small or partially thrombosed and carry a significant risk of recurrence. We discuss a unique case of a 65-year-old woman who presented in 2006 with a subarachnoid hemorrhage and was found to have a ruptured posterior communicating artery and an unruptured P1 aneurysm. Follow-up angiography and imaging showed no changes in the size of a left P1 aneurysm for 11 years (2006–2017). However, in 2021, 15 years after initial presentation, no aneurysm was seen on magnetic resonance angiography, and subsequent digital subtraction angiography in 2022 showed almost complete disappearance of the unruptured P1 aneurysm. Literature review reveals only six reported cases during which a small, unruptured anterior circulation aneurysm disappeared, or regressed on follow-up imaging and no reported cases in the posterior circulation.

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“…When thrombosis occurs, imaging findings can mimic intra-axial neoplasms and patients may undergo oncologic workup with attempted resection of the lesion. 8…”

Section: Discussionmentioning

confidence: 99%

Disappearance of a small unruptured intracranial aneurysm: A case report and brief literature review

et al. 2023

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“…In the literature, nine of ten cases underwent aneurysm trapping and removal of the aneurysm. [ 5 , 7 , 10 , 13 , 14 , 17 , 19 ] In these cases of thrombosed aneurysms, though there was a low possibility of rupture because they were fully thrombosed, the parent artery could be completely controlled by trapping and removal of the aneurysm to prevent bleeding and reduce the mass effect.…”

Section: Discussionmentioning

confidence: 99%

Ring enhanced aneurysm due to vasa vasorum of aneurysm wall mimicking a metastatic brain tumor

Shimizu

Miyashita

Oikawa

et al. 2021

Surgical Neurology International

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Background: A spherical intracranial mass can be occasionally misdiagnosed due to the lack of typical radiographic features. Completely thrombosed intracranial aneurysms (CTIA) are uncommon, but a possible differential diagnosis must be considered to guarantee the best surgical approach for these lesions. Case Description: Here, we report an extremely rare case of a right frontal mass mimicking a brain tumor, in which the surgery unveiled a CTIA of the right middle cerebral artery (MCA). A 56-year-old woman presented with right hemiparesis and mild headache. Magnetic resonance imaging (MRI) revealed a right frontal mass with peripheral edema. The lesion enhanced on initial and follow-up MRI of the brain. Subsequent vascular studies and metastatic workup were negative. A temporal craniotomy with neuronavigation (Brain Lab AG, Germany) was performed and an intraoperative diagnosis of a thrombosed aneurysm along the branch of the MCA was established. The aneurysm was successfully trapped and resected. The patient did not exhibit any postoperative neurological deficits. Conclusion: This is the rare report of a ring enhanced completely thrombosed aneurysm due to vasa vasorum which is misdiagnosed as metastatic brain tumor. In case of an intracranial ring enhanced mass with signs of intralesional hemorrhage and peripheral edema, CTIA should be considered as a possible differential diagnosis.

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“…Magnetic Resonance may demonstrate a lumen with heterogeneous signal on T1- and T2-weighted images, “onion skin” appearance on noncontrast T1 weighted images, a flow void sign, thrombus non-enhancement or rim enhancement along the thrombus margin [12 , 13] . Eleven similar cases have been reported in the literature ( Table 1 ) and were commonly mistaken for neoplasms on initial imaging work up with the final diagnosis commonly established during surgery [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] . Only 3 aneurysms affected the middle cerebral artery.…”

Section: Discussionmentioning

confidence: 99%

Distal middle cerebral artery dissection with concurrent completely thrombosed aneurysm manifesting as cerebral ischemia. A case report and review of the literature

Lamprou

Astreinidis

Davidhi

et al. 2020

Radiology Case Reports

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We report the case of a 70-year-old woman who presented with an acute ischemic stroke involving the left frontal operculum secondary to an M2 dissection and a concomitant completely thrombosed aneurysm of the left distal middle cerebral artery. Initial imaging work-up was inconclusive due to the lack of typical radiographic features and only repeated imaging studies pointed towards the presence of an arterial dissection combined with a completely thrombosed aneurysm. The aneurysm was partially clipped and wrapped with excellent clinical result at 1-year follow-up. The clinical, imaging and therapeutic challenges of this rare entity are discussed.

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A completely thrombosed, nongiant middle cerebral artery aneurysm mimicking an intra-axial neoplasm

Cited by 13 publications

References 23 publications

Disappearance of a small unruptured intracranial aneurysm: A case report and brief literature review

Disappearance of a small unruptured intracranial aneurysm: A case report and brief literature review

Ring enhanced aneurysm due to vasa vasorum of aneurysm wall mimicking a metastatic brain tumor

Distal middle cerebral artery dissection with concurrent completely thrombosed aneurysm manifesting as cerebral ischemia. A case report and review of the literature

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