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| Name | Surgical management of a giant middle cerebral artery aneurysm |
| Video Uploader | Video From Queen Square Simulation Centre |
| Upload Date | This Video Uploaded At 05-08-2025 11:35:42 |
| Video Discription | Giant intracranial aneurysms (larger than 25mm) represent 5% of aneurysms1 and have a poor natural history with high risk of rupture2. We describe a 74-year-old female presenting with cognitive decline and dysphasia, initially having been referred to a memory clinic for a potential diagnosis of dementia. MRI demonstrated a left temporal lobe mass with surrounding oedema, confirmed as a partially thrombosed giant middle cerebral artery aneurysm on catheter angiography. Awake balloon test occlusion was passed without deficit pre-operatively. She then underwent craniotomy with opening of the aneurysm sac under temporary clipping and removal of the thrombus followed by clip reconstruction of the aneurysm neck. Post operative MRI demonstrated resolution of the oedema and mass effect, and angiography confirmed aneurysm occlusion. The dysphasia and cognitive deficits resolved on post-operative psychometric testing. Written patient consent for surgical video publication and institutional approval was obtained. |
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