J Korean Neurosurg Soc.  2007 Dec;42(6):478-480. 10.3340/jkns.2007.42.6.478.

Distal Middle Cerebral Artery M4 Aneurysm Surgery Using Navigation-CT Angiography

Affiliations
  • 1Department of Neurosurgery of East-West Neo Medical Center, Kyung Hee University, School of Medicine, Seoul, Korea. head1975@nate.com

Abstract

Unruptured non-traumatic dissecting aneurysm in the M4 segment of the middle cerebral artery (MCA) accompanied by complete occlusion of the ipsilateral internal cerebral artery (ICA) has never been reported. A 41-year-old man presented with an infarction manifesting as left-sided weakness and dysarthria. Magnetic resonance angiography revealed a subacute stage infarction in the right MCA territory and complete occlusion of the right ICA. Angiography demonstrated aneurysmal dilatation of the M4 segment of the right MCA. Surgery was performed to prevent hemorrhage from the aneurysm. The aneurysm was proximally clipped guided by Navigation-CT angiography and flow to the distal MCA was restored by superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. We report this rare case with literature review.

Keyword

Middle cerebral artery aneurysm; Navigation; Dissecting aneurysm

MeSH Terms

Adult
Aneurysm*
Aneurysm, Dissecting
Angiography*
Cerebral Arteries
Dilatation
Dysarthria
Hemorrhage
Humans
Infarction
Intracranial Aneurysm
Magnetic Resonance Angiography
Middle Cerebral Artery*
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