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Giant thrombosed fusiform aneurysm at the branch of the middle cerebral artery presenting with intramural hemorrhage:a case report Miki FUJIMURA 1,4 , Hirobumi SEKI 1 , Takayuki SUGAWARA 1 , Tsutomu SAKUMA 2 , Yasunari OTAWARA 2 , Norio HARATA 3 1Department of Neurosurgery Iwate Prefectural Central Hospital 2Department of Pathology, Iwate Prefectural Central Hospital 3Harata No-Shinkei-Geka Keyword: giant fusiform aneurysm , thrombosed aneurysm , intramural hemorrhage , cerebral aneurysm pp.151-155
Published Date 1997/2/10
DOI https://doi.org/10.11477/mf.1436901347
  • Abstract
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We report a rare case of a giant thrombosed fusiform aneurysm at the branch of left middle cerebral artery presenting with intramural hemorrhage of the aneu-rysm.

A twenty-year-old man with familial and past history of migraine presented sudden temporalgia on August 13, 1995. Computed tomography (CT) scan on the day of the first attack revealed a well delineated high densi-ty area at the left Sylvian fissure, 2.5cm in diameter. Angiogram showed avascular area corresponding to the lesion, but no visualization of the aneurysm. On Octo-ber 18, this patient presented sudden temporalgia again.CT scan on the day of the second attack indicated new intramural hemorrhage and surgery was performed on October 31. No evidence of subarachnoid hemorrhage was shown during the operation, and the lesion was proven to be a thrombosed fusiform aneurysm at the branch of the middle cerebral artery. The parent artery was clipped at both proximal and distal sides of the aneurysm, and the aneurysm was totally removed with success. Histological finding further supported the idea that the attacks mentioned were due to intramural hemorrhage of the thrombosed aneurysm. Postopera-tive course was uneventful and the patient was dis-charged without any neurological deficit.

Intramural hemorrhage of a giant fusiform aneurysm is relatively rare, only reported in several autopsy cases. Furthermore, we failed to discover any compara-ble cases of giant fusiform aneurysm presenting symp-toms directly caused by intramural hemorrhage of the aneurysm.


Copyright © 1997, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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