Rupture of previously unruptured giant carotid aneurysm after superficial temporal-middle cerebral artery bypass and internal carotid occlusion

• Published in: Neurosurgery Vol. 16; no. 2; p. 177
• Main Authors: Matsuda, M, Shiino, A, Handa, J
• Format: Journal Article
• Language: English
• Published: United States 01-02-1985
• Subjects: Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - surgery; Cerebral Hemorrhage - diagnostic imaging; Cerebral Revascularization; Female; Humans; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - surgery; Middle Aged; Postoperative Complications; Rupture, Spontaneous; Tomography, X-Ray Computed
• ISSN: 0148-396X
• DOI: 10.1227/00006123-198502000-00009

A 51-year-old woman with an unruptured giant aneurysm of the internal carotid artery was treated by gradual occlusion of the internal carotid artery in the neck combined with a superficial temporal artery to middle cerebral artery bypass graft. Visual field defects improved after the operation, and thrombosis of the aneurysm was confirmed by angiography and computed tomography. Nevertheless, a fatal hemorrhage occurred 34 days after the final turn of the Selverstone clamp. The possible mechanism of rupture of the apparently thrombosed aneurysm is discussed. There is a risk of rupture of the aneurysm as long as the aneurysmal lumen remains after proximal ligation, no matter how small it may be.