A challenging case of recurrent and progressive fusiform anterior circulation intracranial aneurysms: illustrative case

Andrew T. Coxon, Anna L. Huguenard, Arindam R. Chatterjee, Ralph G. Ralph

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

BACKGROUND Intracranial fusiform aneurysms are circumferential dilations of cerebral arteries that can lead to complications including ischemic stroke due to vessel occlusion, subarachnoid hemorrhage, or intracerebral hemorrhage. Treatment options for fusiform aneurysms have expanded significantly in recent years. Microsurgical treatment options include proximal and distal surgical occlusion and microsurgical trapping of the aneurysm, usually in association with high-flow bypass procedures. Endovascular treatment options include the placement of coils and/or flow diverters. OBSERVATIONS Here the authors report a case of aggressive surveillance and treatment of a man with multiple progressive, recurrent, and de novo fusiform aneurysms of the left anterior cerebral circulation over 16 years. Because the long-term course of his treatment coincided with the recent expansion of endovascular treatment options, he underwent every type of treatment listed above. LESSONS This case demonstrates the wide range of therapeutic options for fusiform aneurysms and how the treatment model for these lesions has evolved.

Original languageEnglish
Article numberCASE22497
JournalJournal of Neurosurgery: Case Lessons
Volume5
Issue number7
DOIs
StatePublished - Feb 2023

Keywords

  • Pipeline
  • flow diversion
  • flow reversal bypass
  • fusiform aneurysm
  • intracranial aneurysm

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