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Updated: Oct 5, 2025
18:50
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
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A giant basilar artery perforator aneurysm.
Unal Mutlu1, Hans Kortman1, Issam Boukrab2
1Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, PO Box 2040, Rotterdam, CA, 3000 The Netherlands.
Radiology Case Reports
|January 24, 2022
Summary
Basilar artery perforator aneurysms (BAPAs) are rare and can mimic tumors, causing stroke without rupture. Treatment options include conservative management or flow diverter placement, depending on the patient.
Area of Science:
- Neurology
- Vascular Neurology
- Interventional Neuroradiology
Background:
- Basilar artery perforator aneurysms (BAPAs) are uncommon cerebrovascular lesions.
- Their natural history, clinical presentation, and optimal treatment strategies remain poorly defined.
Observation:
- A case report details the largest BAPA documented in medical literature.
- The patient, a 64-year-old woman, presented with pontine ischemia and left hemiparesis, not subarachnoid hemorrhage.
- The BAPA was initially misdiagnosed as a brain tumor.
Findings:
- Successful treatment of the BAPA was achieved using a flow diverter.
- This case demonstrates that BAPAs can present as mass effect lesions, mimicking tumors and causing ischemic events without rupture.
Implications:
- The findings suggest that BAPAs can have varied clinical presentations beyond typical aneurysm rupture.
- Both conservative management and endovascular intervention with flow diverters are potential treatment modalities for BAPAs.
- Treatment decisions should be individualized based on patient factors and preferences.
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