فهرست نشریات علمی دسترسی آزاد ایران

Introduction: The treatment of giant intracranial aneurysms is one of the most challenging cerebrovascular problems of neurosurgery.We report the rupture of a giant, lobulated, and almost completely thrombosed middle cerebral artery (MCA) aneurysmthat is the ninth such report in the literature. We also investigated additional solutions used in the treatment of this patient.Case Presentation: A 58-year-old man had been admitted with headache 8 years previously (in 2005), and a giant MCA aneurysmwas detected. Two separate endovascular interventions were performed, and both failed. The patient began to live with the giantaneurysm. As there was a large thrombosis filling the aneurysmlumen during the previous endovascular procedures, the aneurysmwas not expected to rupture. However, a rupture eventually occurred, in 2013. Even if an aneurysm is very large, lobulated, old,and almost completely thrombosed, it can suddenly bleed. During surgery on this patient, we observed severe cerebral vasospasmcaused by a giant thrombosed aneurysmal rupture. Despite the complications, surgery is a life-saving treatment for this emergencywhen other strategies are not possible. Thrombectomy and clipping are approaches that require a great deal of courage for theneurosurgeon, in terms of entering the risky area within the aneurysm.Conclusions: We believe that it would be more appropriate to plan for combined treatment with surgical and endovascular approachesbefore the emergency condition could occur.