giant cerebral aneurysm

Giant cerebral aneurysms are ones that measure >25 mm in greatest dimension.

Epidemiology

Giant cerebral aneurysms account for ~5% of all intracranial aneurysms . They occur in the 5-7 decades and are more common in females .

Clinical presentation

Patients can present with symptoms and signs of mass effect or subarachnoid hemorrhage .

Pathology

Most commonly represent saccular cerebral aneurysms but may also be fusiform or serpentine in morphology . They are thought to develop via two pathways :

  • internal elastic lamina de novo defect
  • enlargement from a smaller aneurysm
Location

Compared to non-giant cerebral aneurysms there is an increased incidence in the posterior circulation (~35%) .

Radiographic features

Appearances will depend on whether the aneurysm is non-thrombosed, or partially or completely thrombosed.

CT
  • non-contrast: slightly hyperdense, well-defined round extra-axial masses
  • may demonstrate a peripheral calcified rim

Treatment and prognosis

There are a variety of endovascular and open surgical techniques to treat these aneurysms. Endovascular options have a lower morbidity .

See also

Siehe auch: