Giant fusiform aneurysm of the vertebro-basilar artery presenting with stroke

The authors describe a case of giant fusiform aneurysm of the basilar artery presenting with ischemic symptoms. Angiography and CT revealed vertebro-basilar fusiform aneurysmal dilatation. Fusiform vertebro-basilar ancurysm is associated with various complications particularly brain stem infarction. Similar lesions in the literature are reviewed and the relationship between this clinical entity and cerebral ischemia, particularly brainstem infarction are discussed.     

Giant basilar artery aneurysm presenting as a third ventricular tumor

Giant aneurysm of the basilar artery presenting as a 3rd ventricular tumor is an unusual phenomenon. We are reporting a case in which a patient with a giant aneurysm of the basilar artery presented with symptoms of headaches and gait disturbance secondary to obstructive hydrocephalus. Although giant aneurysms presenting as mass lesions have been reported, the computed axial tomographic findings in our case were unique. Giant aneurysms of the basilar artery may be considered in the differential diagnosis of 3rd ventricular tumors.     

Giant fusiform aneurysm of the middle cerebral artery: successful Hunterian ligation without distal bypass

Giant fusiform aneurysm is a rare vascular lesion which presents difficult management issues. We describe one such aneurysm in a middle cerebral artery branch (M2) that presented with subarachnoid haemorrhage and was managed operatively. Clinical, radiological and pathological presentations, as well as the different treatment options for this type of aneurysm are discussed based on a literature review. A satisfactory results in an M2 giant fusiform aneurysm can be achieved with Hunterian ligation of the parent vessel even when a distal EC-IC bypass is not possible.     

Giant fusiform aneurysm of the middle cerebral artery treated with extracranial-intracranial arterial bypass and Drake tourniquet

A giant fusiform aneurysm of the right middle cerebral artery was treated with extracranial-intracranial arterial bypass followed by controlled occlusion of the proximal parent artery using a Drake tourniquet. Thrombosis of the aneurysm is documented, with the distal extremity of the lesion being smoothly contrasted in a retrograde fashion by the hypertrophied bypass. The low risk as well as effectiveness of this combined approach to inaccessible intracranial aneurysms is confirmed.     

Vascular reconstruction of a fusiform basilar aneurysm with the Silk embolization system

We present the case of a 47-year-old man with a fusiform aneurysm of the basilar cerebral artery, who was successfully treated with the placement of a novel flow diverter system (Silk stent).     

Normal pressure hydrocephalus and basilar artery aneurysm. Case report and pathogenetic consideration.

The authors describe the case of a 60-year-old patient with basilar artery aneurysm who in time developed normal pressure hydrocephalus (NPH). Clinical examinations and laboratory tests did not reveal other data from which the pathology could be attributed to causes other than the vascular malformation already considered. The mechanical obstruction exerted by the aneurysm lodged on the floor of the third ventricle represents, according to the authors, the physiopathogenetic mechanism by which a temporal delay is developed between the endoventricular pulsation and that of the cerebral veins so as to produce a precise pulsatile gradient in a centrifugal direction to allow the formation of an active hydrocephalus proportional to the entity of cerebrospinal fluid (CSF) pulse.     

Giant splenic artery aneurysm

Giant aneurysms of the splenic artery are uncommon. The mean size of splenic artery aneurysms is reported to be 2.1 cm; they are rarely larger than 3 cm. We present two cases in which the splenic artery aneurysm was larger than 8 cm, discuss the management and operative approach to these infrequently encountered entities, and provide a brief review of the relevant literature.     

Giant fusiform aneurysm in middle cerebral artery branches: a report of two cases and a review of the literature

Summary Giant fusiform aneurysm (2.5 cm in length or more) is an unusual pathological entity typically described involving the main trunks of cerebral arteries and, rarely, cerebral artery branches. We are presenting two cases of middle cerebral artery branch giant fusiform aneurysm, one surgically and the other conservatively treated. We were unable to find in the literature reports of similar aneurysms at the same location. Clinical and pathological aspects, radiological findings, and treatment are discussed.     

Treatment of giant fusiform aneurysms of the basilar trunk with intra-aneurysmal and basilar artery coil embolization

OBJECTIVE: The authors report their experience in endovascular treatment of basilar artery (BA) trunk aneurysms by intra-aneurysmal and BA occlusion. METHODS: Four patients were referred to our hospital from 1995 until 2002 with variable clinical presentations and radiologic appearances. All the patients were subjected for tolerability to balloon BA occlusion test to verify the collateral supply from the posterior communicating arteries. The patients were treated by intra-aneurysmal embolization together with basilar artery occlusion. RESULTS: All the aneurysms were successfully isolated from the circulation. Transient postoperative neurologic deficits were constant findings in all the cases. Outcome was finally good for all the patients. CONCLUSIONS: Endovascular treatment of complex BA trunk aneurysm by intra-aneurysmal embolization and BA occlusion method is a valuable alternative for management and successful isolation in patients with good collateral arterial flow.     

Giant aneurysm of the pericallosal artery

A rare case of a giant aneurysm of the pericallosal artery, evaluated by computed tomography, magnetic resonance imaging, and angiography, is reported, and the other 7 cases in the literature are reviewed. Giant aneurysms are exceptional in the distal segments of the anterior cerebral arteries, and may simulate a callosal tumor or hematoma on computed tomographic scan. The clinical, radiological, surgical, and pathological findings of giant aneurysms of this location are discussed and the other reported cases are analyzed. The role of magnetic resonance imaging in diagnosing and characterizing giant aneurysms is stressed.     

Fenestrated basilar artery aneurysm: case report]

The authors reported an operated case with an aneurysm arising from the proximal end of basilar artery fenestration, and discussed its etiology and surgical strategy. A 47-year-old woman presented with slight memory disturbance. Neuroradiologic examination revealed an aneurysm located on the proximal end of the basilar artery 12 x 9 mm in size at the level of the outer auditory meatus. The union of vertebral arteries had deviated toward the right side, and the aneurysmal dome had projected into the fenestration. Through the right far lateral approach, we applied two straight fenestrated clips X configuration to the aneurysm. Several authors have reported a variety of approaches for vertebrobasilar aneurysms along the midline with consideration of the height of the aneurysmal. However, another point of view is that attention should be paid to the direction of the clip blade and applied at the final clipping, because, for vertebrobasilar aneurysms adjacent to the midline, the surgical view and working space are extremely restricted.     

Giant fusiform middle cerebral aneurysm: successful treatment utilizing microvascular bypass.

A case of giant middle cerebral fusiform aneurysm is presented. The aneurysm was treated by superficial temporal-middle cerebral artery anastomosis and obliteration of the aneurysm by trapping. The application of extracranial to intracranial anastomosis to the problem is discussed.     

Embolic bacterial aneurysm of the basilar artery: case report

A patient with basilar artery rupture caused by a septic embolus originating from a mitral valve vegetation is reported. The pathogenesis, investigation and management of infected cerebral aneurysms are reviewed.