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Case Studies | Neuroscience | India | Volume 12 Issue 8, August 2023

Spontaneous Occlusion of Giant ICA Aneurysm and Presentation with Ischemia: Treatment with Bypass

Dr. Tejesh Shavi | Dr. Paritosh Pandey

Abstract: Background: Stroke caused by spontaneous thrombosis of an unruptured intracranial aneurysm is a rare event. Surgical management of such aneurysms arouses many complexities for the neurosurgeon and an analytical decision with regards to above is the need of the hour. Case Presentation: We report a case of a 54-year-old male who experienced recurrent ischemic attacks and cerebral infarctions due to spontaneous thrombosis of an unruptured left internal cerebral artery bifurcation aneurysm. Spurts of emboli into the ipsilateral ACA and MCA, resulting in ischemic infarction in both the vascular territories, was diagnosed by CT scanning, MRI, and cerebral angiography and was surgically successfully managed by left STA-MCA bypass technique. Conclusion: Thrombosis is one of the most significant events in the natural history of giant aneurysms, and partial thrombosis does not preclude the risk of rupture. Thrombosed aneurysms may display additional growth brought about by wall dissections or intramural hemorrhages. Surgical treatment of thrombosed aneurysms is the preferred treatment since it has been shown to alleviate TIAs and would reduce the risk of subarachnoid hemorrhage. Non-conventional surgical techniques are discussed in correlation to the microsurgical management of these aneurysms. Isolated bypass technique can be considered as a better alternative to direct clipping of the aneurysm in such cases.

Keywords: Giant ICA Aneurysm, Ischemia, Stroke

Edition: Volume 12 Issue 8, August 2023,

Pages: 1700 - 1705