Giant intracranial aneurysms: diagnosis with special reference to computerised tomography

Area of Science:

• Neurosurgery
• Neuroradiology
• Vascular Neurology

Background:

• Giant intracranial aneurysms (>2.5 cm) pose significant diagnostic and therapeutic challenges.
• Review of clinical presentation, radiological findings, and surgical management in 11 patients.

Observation:

• Hemorrhage was the predominant clinical presentation.
• Intracranial calcification on plain films and high-density space-occupying lesions on CT scans were key findings.
• CT enhancement patterns varied (homogeneous or rim enhancement).

Findings:

• CT findings sometimes mimicked neoplasms.
• Arteriography often underestimated aneurysm size and occasionally failed to visualize the aneurysm.
• Direct surgical attack was the preferred management over carotid ligation.

Implications:

• Direct surgical intervention is effective for giant intracranial aneurysms.
• Radiological findings, particularly CT, require careful interpretation due to potential mimicry of other pathologies.
• Improved diagnostic accuracy and surgical techniques are crucial for managing these complex vascular lesions.