[A growing complex cerebral artery aneurysm treated with cerebral bypass]

Area of Science:

• Neurosurgery
• Vascular Neurology
• Interventional Neuroradiology

Background:

• Giant fusiform middle cerebral artery (MCA) aneurysms are uncommon intracranial vascular lesions.
• Obliterating these aneurysms presents significant challenges for neurosurgeons and interventionalists.
• Endovascular techniques are evolving but may not always be sufficient for complex aneurysms.

Observation:

• A case of a fusiform MCA aneurysm is presented.
• This specific aneurysm continued to enlarge despite undergoing endovascular treatment.
• The aneurysm was ultimately treated surgically.

Findings:

• The fusiform MCA aneurysm was successfully managed using an extracranial-to-intracranial bypass combined with aneurysm trapping.
• This surgical approach provided a definitive solution for the growing aneurysm.
• The treatment highlights the efficacy of bypass surgery in complex cases.

Implications:

• Cerebral bypass techniques remain crucial in neurovascular surgery.
• This case underscores the limitations of current endovascular treatments for certain complex aneurysms.
• Surgical revascularization strategies are vital adjuncts to endovascular interventions.