Thrombosed Giant Aneurysm of the Pericallosal Artery With Inconclusive Findings of Multiple Neuroimaging Studies -Case Report-

Abstract

A 65-year-old woman presented with a thrombosed giant pericallosal artery aneurysm manifesting as headache and memory loss that developed over a 2-year period. Computed tomography (CT), magnetic resonance (MR) imaging, and conventional and CT angiography could not establish the differential diagnosis. Open craniotomy revealed the mass as thrombosed giant aneurysm from the pericallosal artery. Direct clipping with thrombectomy was performed successfully with an uneventful postoperative course. Thrombosed giant aneurysm of the distal anterior cerebral artery should be considered in the differential diagnosis of an unusual mass in the mid-frontal area, particularly in the presence of inconclusive angiographic and MR imaging findings.

Giant pericallosal artery aneurysm – Literature review and report of a rare case

“…Reports of giant (> 2,5 cm) PAA are extremely uncommon in the literature 2,3,5,13 and are not even mentioned in some series about giant aneurysms. 14,15 Since Drake's description of a ruptured giant PAA causing SAH in 1979, 33 additional cases have been reported until 2012, 7,12,16 including this one.…”

“…Pericallosal artery aneurysms (PAA) are rare lesions. [1][2][3][4][5] They account for less than 5% of all saccular intracranial aneurysms, 2,[5][6][7][8] usually have small size 1,2,5,9 and are frequently associated with multiple lesions. 1,3,5 Giant pericallosal artery aneurysms are even more uncommon and may present with subarachnoid hemorrhage (SAH), mass effect, distal embolization or acute swelling after rapid and massive intraluminal thrombosis.…”

Thrombosed giant aneurysm of the distal anterior cerebral artery treated with aneurysm resection and proximal pericallosal artery-callosomarginal artery end-to-end anastomosis: Case report and review of the literature

“…reviewed the largest series of 26 cases of giant DACA aneurysms. [8] We reported here six more cases[3121321] and one additional case of our own, thereby reviewing a total of 33 cases[3–131517–2123–2729–3234] [Table 1]. Thirty of the 33 cases were treated surgically, and the neck was clipped in 13 of them.…”

“…Thirty of the 33 cases were treated surgically, and the neck was clipped in 13 of them. [7910131518212627313234] Only four cases were treated with bypass surgery, and good outcomes were obtained in all of them. The first bypass surgery, including aneurysm resection and end-to-end anastomosis of ACA, was reported in 1982.…”

“…To our knowledge, 32 cases have been reported, including only 3 cases treated with bypass surgery. [3–79–131517–2123–2729–3234]. …”