Intracranial Mirror Aneurysms of the Sylvian Artery: About A Case at the Neurosurgery Clinic of the Fann University Hospital in Dakar

Abstract

Introduction: Bilateral aneurysms of the sylvian artery are rare with an incidence of approximately 1% of all intracranial aneurysms and difficult surgical management. We report a case of an intracranial mirror aneurysm of the sylvian artery, revealed by subarachnoid hemorrhage.Observations: A 47-year-old man, with no particular pathological history, seen in the emergency room for an intense ictal headache from the beginning with a one-sided left type of stabbing at first unilateral left then holocranial with brief initial loss of consciousness. The neurological exam was normal. Cerebral computed tomography (CT) coupled with cerebral CT angiography revealed a subarachnoid hemorrhage in the left insular lobe and a mirror aneurysm at the junctions of the M1 and M2 portions of the sylvian arteries, treated by clipping the aneurysm ruptured by the left pterional craniotomy with simple postoperative consequences. Conclusion:intracranial mirror aneurysms of the sylvian artery are rare. Their surgical management is difficult and can be performed unilaterally or bilaterally in one or two operating times.