{"id":"140a57a0-1258-4fca-944d-d46ada3e6344","slug":"sni-17-553","title":"Partially thrombosed anterior communicating artery aneurysm mimicking a suprasellar tumor: Microsurgical reconstruction after aneurysmotomy and ultrasonic thrombectomy","authors":["José Luis Quelho Filho","Pedro Henrique Argentato Brassarola","Paulo Eduardo Albuquerque Zito Raffa","Leonardo Vieira Nunes","Leonardo Peixoto Garcia","Rodrigo Shibaki","Lucas Crociati Meguins","Eberval Gadelha Figueiredo"],"abstract":"Background: Partially thrombosed intracranial aneurysms are uncommon lesions that may mimic intracranial neoplasms because of their heterogeneous radiological appearance and mass effect. When associated with broad-neck morphology and incorporation of adjacent vessels, treatment may require complex microsurgical reconstruction. Case Description: A 69-year-old woman with hypertension and type 2 diabetes mellitus underwent investigation after a mild traumatic brain injury. Initial computed tomography (CT) demonstrated a suprasellar lesion suggestive of a neoplastic process. CT angiography and digital subtraction angiography subsequently revealed a partially thrombosed anterior communicating artery aneurysm measuring 19 × 10 mm with a 6.6-mm neck and incorporation of the right A2 segment into the aneurysm neck. The patient underwent elective microsurgical treatment through a right fronto-orbital approach. Following temporary vascular control, aneurysmotomy and ultrasonic thrombectomy using the Clarity ® system were performed. Definitive reconstruction required sequential placement of eight permanent clips while preserving both A2 segments. Intraoperative fluorescein angiography confirmed adequate vessel patency. The patient remained neurologically intact, with a modified Rankin Scale score of 0 at 90-day follow-up. Conclusion: Partially thrombosed anterior communicating artery aneurysms may mimic suprasellar tumors and represent an important diagnostic challenge. In selected cases with branch incorporation, broad-neck morphology, and significant thrombotic burden, microsurgical reconstruction remains a safe and effective treatment strategy. Aneurysmotomy combined with ultrasonic thrombectomy facilitates visualization of the true aneurysm neck and may assist complex clip reconstruction.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/sni-17-553/figures/SNI-17-553-g002.jpg","publishDate":"2026-10-02T00:00:00.000Z","doi":"10.25259/SNI_783_2026","categories":["Neurovascular","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/140a57a0-1258-4fca-944d-d46ada3e6344/pdf"}