Management of Aneurysms at the Origin of Duplicated Middle Cerebral Artery: Series of Four Patients with Review of the Literature

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• 作者：Ahmed Elsharkawy ; Keisuke Ishii ; Mika Niemel盲 ; Riku Kivisaari ; Hanna Lehto ; Juha Hernesniemi
• 关键词：Cerebral aneurysm ; Clipping ; Computed tomography angiography ; Conservative management ; Duplication of middle cerebral artery ; Lateral supraorbital approach ; Subarachnoid hemorrhage ; Variation of cerebral artery
• 刊名：World Neurosurgery
• 出版年：December, 2013
• 年：2013
• 卷：80
• 期：6
• 页码：e313-e318
• 全文大小：5097 K

文摘

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Objective

To review the management of aneurysms arising at the origin of a duplicated middle cerebral artery (DMCA), which is an extremely rare entity.

Methods

Four patients with internal carotid artery-DMCA aneurysms are presented, and 24 previously published cases are reviewed.

Results

Of the 28 internal carotid artery-DMCA aneurysms, 17 were ruptured, and 11 were unruptured. The aneurysms were equally distributed on the right and left sides and were small in size (鈮? mm) except for two that were of medium size. All aneurysms were treated surgically except for two very small aneurysms, which have been managed conservatively and followed for 9 years.

Conclusions

Although all previously published clinical cases of internal carotid artery-DMCA aneurysms were treated surgically, conservative management with follow-up is a viable option in very small unruptured aneurysms.