{"id":"cdfd3669-33a7-4483-b029-80c18470348b","slug":"massive-intracerebral-hemorrhages-due-to-peripheral-middle-cerebral-artery-aneurysm-rupture-a-case-report-with-a-surgical-video","title":"Massive intracerebral hemorrhages due to peripheral middle cerebral artery aneurysm rupture: A case report with a surgical video","authors":["Takuma Aoki","Yukihiro Goto","Yujiro Komaru","Shigeomi Yokoya","Hideki Oka"],"abstract":"Background: Saccular aneurysm in the distal segment of the middle cerebral artery (DMCA) occurs very rarely and often represents with a rupture. We report a successful surgical case of a DMCA aneurysm rupture with large cerebral and subarachnoid hemorrhage. Case Description: A 44-year-old female presented a sudden onset headache and coma (the Glasgow Coma Scale was 3). Head computed tomography (CT) revealed a subarachnoid hemorrhage around the right Sylvian fissure and large intracranial hematoma in the right parietal lobe. The CT angiography showed a saccular aneurysm in the peripheral cortical segment of the right angular branch of the right DMCA. We decided to perform a right craniotomy to evacuate hematoma and interrupt the aneurysm. Just after the dural incision, the aneurysm ruptured again. We applied a temporary clip on the artery proximal to the aneurysm before excising it. Conclusion: Aneurysm in DMCA can be treated safely with surgical excision and risk of sudden recurrent hemorrhage needs to be anticipated.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/cdfd3669-33a7-4483-b029-80c18470348b/featured/hero-1781562122260.png","publishDate":"2021-08-16T00:00:00.000Z","doi":"10.25259/SNI_479_2021","categories":["Unique Case Observations","Image Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2021/08/11044/SNI-12-412.pdf"}