Reconstruction of the middle cerebral artery after excision of a giant fusiform aneurysm

Abstract

A patients with a giant fusiform aneurysm of the left inferior trunkus of the middle cerebral artery (MCA) is presented. The size of the aneurysm was 5 cm at its largest diameter. Retrograde flow was well developed. After the application of temporary clips the aneurysm was excised and microsurgical reconstructions were undertaken. Adequate flow in the reconstructed MCA trunkus was maintained. This rare case is discussed in the light of the literature.

Intracranial Fusiform Aneurysms: It's Pathogenesis, Clinical Characteristics and Managements

“…This contrasts with that of patients with saccular aneurysms 36) . Our study confirms previous reports that spontaneous fusiform aneurysms are more often found in younger patients 2,4,6,9,13,19,26,29,31,34,35) and are more frequent in men 6,13,28,35) .…”

“…It is defined as a circumferential arterial dilatation resulting from pathological involvement of the entire artery 2,4,9,28,34) . All aneurysms exhibit a spindle shape when viewed externally 6) .…”

“…However, the classic dissecting aneurysm also has a fusiform appearance 23) and several authors have recently reported the presence of fusiform aneurysms caused by dissection [2][3][4][5][6][9][10][11]13,16,17,21,23,24,26,34) . Therefore, all cases of fusiform aneurysms based on external view without Intracranial Fusiform Aneurysm｜SH Park, et al…”

“…Fusiform aneurysms are nonsaccular dilatations involving the entire vessel wall for a short distance 2,4,9,25) . They are termed cylindrical if it involves a somewhat longer length 34) .…”

“…Fusiform aneurysms in the anterior circulation remain rare and occur mostly in the middle cerebral artery and internal carotid artery 6,13) . There are some sporadic case reports about the treatment of fusiform aneurysms 2,4,13,34) and a few reports on the clinical characteristics, pathogenesis and treatment methods of these aneurysms in large series [6][7][8]11) . We have reviewed 22 cases of fusiform aneurysms that have been treated at our institute, and we describe the clinical characteristics, treatment methods and outcomes after management of patients with these lesions.…”