{"id":"7b0fa7a3-5214-4075-b68f-65c70352a025","slug":"middle-cerebral-artery-fusiform-aneurysm-presented-with-stroke-and-delayed-subarachnoid-hemorrhage-trapping-thrombectomy-and-bypass","title":"Middle cerebral artery fusiform aneurysm presented with stroke and delayed subarachnoid hemorrhage trapping, thrombectomy, and bypass","authors":["Goran Mrak","Kresimir Sasa Duric","Jakob Nemir"],"abstract":"Background: Ischemic stroke is a well-described but less frequent consequence of ruptured or unruptured intracranial aneurysms. To date, the optimal form of treatment for patients with a thrombosed cerebral aneurysm has not yet been well-defined. Case Description: Here, we report a case of a 68-year-old female patient presenting with cerebral stroke. Five days poststroke multislice computed tomography (MSCT) and MSCT angiography were performed for the evaluation of clinical deterioration, showing a left M2 middle cerebral artery (MCA) bifurcation aneurysm and subarachnoid hemorrhage. Having in mind the high mortality and morbidity rates after a re-rupture, as well as the digital subtraction angiography features of the aneurysm, urgent surgery was performed consisting of aneurysm trapping and superficial temporal artery (STA) to M3 MCA segment end-to-side anastomosis. The surgery and early postoperative period proceeded uneventfully and the patient gradually recovered from the previously diagnosed expressive dysphasia and cranial and extremity motor deficit. Conclusion: Our case describes a complex aneurysm treatment that consisted of aneurysm trapping, thrombus removal and an STA-M3 MCA branch bypass creation for the protection of the patent M3 insular MCA branch and prevention of further ischemia. This procedure rewarded us with an excellent clinical result.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/7b0fa7a3-5214-4075-b68f-65c70352a025/featured/hero-1782420934721.png","publishDate":"2016-04-01T00:00:00.000Z","doi":"10.4103/2152-7806.179571","categories":["Neurovascular","Case Report"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2016/04/6658/SNI-7-209.pdf"}