Thrombosis and recanalization of symptomatic nongiant saccular aneurysm

Complete thrombosis followed by recanalization of giant aneurysms is an infrequent process that has been exceptionally mentioned in relation to nongiant saccular aneurysms. A 25-year-old male presented with a right temporal hematoma and associated subarachnoid hemorrhage. Cerebral angiography revealed a small blister-like dilatation at the right middle cerebral artery bifurcation. The cerebral hematoma was surgically removed and a large thrombosed aneurysm was discovered and was wrapped. Follow-up angiography revealed complete recanalization of the aneurysm with preservation of all the arterial branches and the aneurysm was then completely occluded with detachable coils. This case provides insight into the well-known but poorly understood dynamic process of thrombosis and recanalization of cerebral aneurysms. The possible role of a cerebral hematoma in the pathogenesis of this process is discussed.