[Giant fusiform partially thrombosed aneurysm of fenestrated middle cerebral artery]

Area of Science:

• Neurosurgery
• Vascular Neurology
• Cerebrovascular Diseases

Background:

• Giant fusiform aneurysms, particularly those involving fenestrated arteries, are rare and pose significant surgical challenges.
• Fenestration of the middle cerebral artery (MCA) is an anatomical variation that can complicate aneurysm management.

Observation:

• A 15-year-old patient presented with a ruptured, giant, fusiform, and partially thrombosed aneurysm of a fenestrated MCA.
• Intraoperative findings detailed the specific signs of MCA fenestration, presenting as a 'double-necked' appearance of the aneurysm.

Findings:

• The patient successfully underwent surgical treatment, including clipping of the aneurysm's proximal and distal necks and thrombectomy.
• The surgical approach effectively addressed the complex anatomy of the fenestrated MCA aneurysm.

Implications:

• This case provides valuable insights for neurosurgeons managing similar rare cerebrovascular lesions.
• Accurate identification of MCA fenestration during surgery is crucial for selecting appropriate aneurysm occlusion techniques and ensuring patient safety.