Treatment of a Giant Serpentine Aneurysm in the Anterior Cerebral Artery.
Sung Tae KimYoung-Gyun JeongHae Woong JeongPublished in: Journal of cerebrovascular and endovascular neurosurgery (2016)
A giant serpentine aneurysm (GSA) in the anterior cerebral artery (ACA) poses a technical challenge in treatment given its large size, unique neck, and dependent distal vessels. Here we report the case of a GSA in the ACA successfully treated with a combined surgical and endovascular approach. A 54-year-old woman presented with dull headache. On brain computed tomography (CT), a large mass (7 cm × 5 cm × 5 cm) was identified in the left frontal lobe. Cerebral angiography revealed a GSA in the left ACA. Bypass surgery of the distal ACA was performed, followed byocclusion of the entry channel via an endovascular approach. Follow-up CT performed 5 days after treatment revealed disappearance of the vascular channel and peripheral rim enhancement. Follow-up imaging studies performed 7 months after treatment revealed gradual reduction of the mass effect and patency of bypass flow. No complications were noted over a period of 1 year after surgery.
Keyphrases
- computed tomography
- minimally invasive
- subarachnoid hemorrhage
- image quality
- dual energy
- positron emission tomography
- contrast enhanced
- single cell
- coronary artery
- magnetic resonance imaging
- cerebral ischemia
- affordable care act
- risk factors
- white matter
- combination therapy
- rare case
- surgical site infection
- blood brain barrier