title: Endovascular Treatment of Giant Serpentine Aneurysm of the Middle Cerebral Artery.
abstract: Giant serpentine aneurysms are uncommon types of aneurysmal disease and have angiographically authentic features. We report a case of a 44-year-old male with headache and seizure. He presented a giant serpentine aneurysm arising from the middle cerebral artery (MCA). It was a large intracranial aneurysm thrombosed as a mass-like lesion while it maintained its outflow drainage into the distal MCA branches. The balloon occlusion test (BOT) was performed to test the tolerance of temporary collateral circulation. Following routine cerebral angiography, we performed an endovascular embolization on the proximal artery of MCA. He was discharged from the hospital with alert mental status and mild Gerstmann syndrome. The short-term follow-up imaging studies showed the decreased mass effect, and the patient presented an improved Gerstmann syndrome. After a careful evaluation of BOT, an endovascular embolization can be one of the powerful therapeutic instruments for giant serpentine aneurysm.
authors.affiliation: Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Young Ha
authors.initials: YH
authors.lastname: Jeong
authors.affiliation: Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Jong Yeon
authors.identifier: 0000-0002-9407-0127
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Youn Moo
authors.initials: YM
authors.lastname: Koo
authors.affiliation: Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Kum
authors.initials: K
authors.lastname: Whang
authors.affiliation: Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Chul
authors.initials: C
authors.lastname: Hu
authors.affiliation: Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Sung Min
authors.initials: SM
authors.lastname: Cho
keywords: Balloon occlusion; Endovascualr technique; Giant aneurysm