title: Giant serpentine aneurysm of the distal anterior cerebral artery.
abstract: We report a case of a 38-year-old man with a giant serpentine aneurysm arising from the distal anterior cerebral artery. This aneurysm grew from a fusiform aneurysm to a huge aneurysm within 5 months before manifesting as a mass lesion. The aneurysm was largely filled with thrombus, and 4 distal branches arose from the aneurysm dome. Selective balloon test occlusion of the distal anterior cerebral artery using an intravascular technique was performed to confirm the tolerance of the brain tissue. The balloon test occlusion elicited adequate leptomeningeal collateral circulation and no neurologic symptoms; thus, the aneurysm was treated with trapping and resection. The patient had no ischemic complications after the surgery and returned to his job 1 month later. No ischemia developed in the 2 years after surgery. Selective balloon test occlusion of the distal cerebral artery using an intravascular technique can be a very useful tool in planning the therapeutic strategy for a complicated distal cerebral aneurysm.
authors.affiliation: Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Yamanashi, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Senbokuya
authors.forename: Kazuya
authors.initials: K
authors.lastname: Kanemaru
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kinouchi
authors.forename: Toru
authors.initials: T
authors.lastname: Horikoshi
mesh_terms: D000328:Adult; D020771:Anterior Cerebral Artery / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D021721:Balloon Occlusion; D002533:Cerebral Angiography / Q000379:methods; D002560:Cerebrovascular Circulation; D003097:Collateral Circulation; D003399:Craniotomy; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D008297:Male; D055420:Perfusion Imaging / Q000379:methods; D011237:Predictive Value of Tests; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures