“Flow Reversal” and Cure in a Case of Giant Intracranial Aneurysm: A Case Report

Abstract

We describe the case of an 11-year-old girl having a giant anterior circulation aneurysm. The ipsilateral internal carotid artery was entirely blocked and the aneurysm was supplied by posterior circulation. Following a high-flow bypass that connected the external carotid artery to the middle cerebral artery, the giant aneurysm thrombosed spontaneously. We discuss several relatively rare and unique features of the case.

Keywords

giant aneurysm - flow diversion - internal carotid artery - high-flow bypass

Publication History

Received: 06 September 2020

Accepted: 28 October 2020

Article published online:
02 June 2021

• References

• 1 Lonjon M, Pennes F, Sedat J, Bataille B. Epidemiology, genetic, natural history and clinical presentation of giant cerebral aneurysms. Neurochirurgie 2015; 61 (06) 361-365
• 2 Pruvot AS, Curey S, Derrey S, Castel H, Proust F. Giant intracranial aneurysms in the paediatric population: suggested management and a review of the literature. Neurochirurgie 2016; 62 (01) 20-24
• 3 Ferracci FX, Gilard V, Cebula H. et al. Growth of giant intracranial aneurysms: an aneurysmal wall disorder?. Neurochirurgie 2017; 63 (01) 6-12
• 4 Yeh H, Tomsick TA. Obliteration of a giant carotid aneurysm after extracranial-to-intracranial bypass surgery: case report. Surg Neurol 1997; 48 (05) 473-476
• 5 Cantore G, Santoro A, Da Pian R. Spontaneous occlusion of supraclinoid aneurysms after the creation of extra-intracranial bypasses using long grafts: report of two cases. Neurosurgery 1999; 44 (01) 216-219 , discussion 219–220
• 6 Kalani MY, Zabramski JM, Nakaji P, Spetzler RF. Twenty-year follow-up of flow reversal and revascularization for a giant serpentine basilar artery aneurysm. Neurosurgery 2014; 10 (Suppl. 03) E493-E497 , discussion E497
• 7 Kalani MY, Zabramski JM, Nakaji P, Spetzler RF. Bypass and flow reduction for complex basilar and vertebrobasilar junction aneurysms. Neurosurgery 2013; 72 (05) 763-775 , discussion 775–776
• 8 Wang L, Shi X, Qian H. Flow reversal bypass surgery: a treatment option for giant serpentine and dolichoectatic aneurysms-internal maxillary artery bypass with an interposed radial artery graft followed by parent artery occlusion. Neurosurg Rev 2017; 40 (02) 319-328
• 9 Li Y, Payner TD, Cohen-Gadol AA. Spontaneous regression of an intracranial aneurysm after carotid endarterectomy. Surg Neurol Int 2012; 3: 66
• 10 Hans FJ, Krings T, Reinges MH, Mull M. Spontaneous regression of two supraophthalmic internal cerebral artery aneurysms following flow pattern alteration. Neuroradiology 2004; 46 (06) 469-473