Extensive organization in a thrombosed giant intracranial aneurysm: case report

A 58-year-old man presented with a 4-month history of personality changes and transient episodes of right lower extremity weakness, as well as transient episodes of aphasia. Computerized tomography revealed a large basal frontotemporal mass with extensive surrounding edema which was confirmed on angiography to be a partially thrombosed giant aneurysm. Pathologically, the lesion was extraordinary, demonstrating extensive organization, with the entire cavity of the aneurysm occupied by vascular channels of different sizes, some of which were thrombosed. These findings were substantiated by scanning electron microscopy which also illustrated areas of active platelet-fibrin interaction on the remaining luminal surface.