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Related Experiment Video

Updated: Jun 28, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

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Peripheral intracranial aneurysms: management challenges in 60 consecutive cases.

Eric S Nussbaum¹, Michael T Madison, James K Goddard

¹National Brain Aneurysm Center, St. Joseph's Hospital, St. Paul, Minnesota, USA. lnussbaum@comcast.net

Journal of Neurosurgery

|October 22, 2008

Summary

Managing rare peripheral intracranial aneurysms in 55 patients presented unique challenges. Despite difficulties with standard treatments, most patients achieved good outcomes with parent artery preservation.

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Area of Science:

Neurosurgery
Vascular Neurology
Interventional Neuroradiology

Background:

Intracranial aneurysms distal to major branching points are uncommon.
These peripheral aneurysms pose distinct therapeutic difficulties.

Purpose of the Study:

To analyze the management and outcomes of patients with peripheral intracranial aneurysms.
To evaluate treatment strategies for these rare cerebrovascular lesions.

Main Methods:

Retrospective review of a neurovascular service database (July 1997-December 2006).
Identification and exclusion of mycotic aneurysms and those associated with arteriovenous malformations or atrial myxomas.
Analysis of surgical and endovascular treatment modalities and patient outcomes.

Main Results:

Sixty peripheral intracranial aneurysms were identified in 55 patients.
Surgical intervention was employed for 53 aneurysms using various techniques; endovascular coiling was used for 6.
Good outcomes were achieved in 49 patients, with 4 new neurological deficits and 2 deaths.

Conclusions:

Peripherally located intracranial aneurysms are rare and challenging to manage.
While standard clipping or coiling is often difficult, parent artery preservation is frequently achievable.
The majority of patients treated for these rare aneurysms experienced favorable outcomes.