Giant unruptured intracranial aneurysm

¹Department of Neurosurgery, Avicenne Military Teaching Hospital, University Caddi Ayyad, Marrakech, Morocco

^&Corresponding author
Hassan Baallal, Department of Neurosurgery, Avicenne Military Teaching Hospital, University Caddi Ayyad, Marrakech, Morocco

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Giant intracranial aneurysms (GIAs) are rare and heterogeneous lesions with complex vascular anatomy and represent almost 5% of intracranial aneurysms. The formation and growth of an aneurysm is the result of a complex interaction of multiple factors. In addition to genetic, physiological, environmental factors, and tissue mechanics, it is believed that fluid dynamics play an important role in the formation and development of arterial aneurysms at certain sites. The majority of the brain aneurysms are observed at bifurcations or arterial branches located in the circle of Willis where the flow topology is complex. In this report, we present a 55-year-old woman patient who was referred to our neurosurgical department with a three years history of an intermittent holocephalic headache, beginning cognitive deficits and lethargy magnetic resonance imaging (MRI) obtained from the referring hospital reported supra-sellar mass, 55 mm in diameter with a crescent shaped hypo-intensity of the lesion wall in the T1-weighted frame (A) and T2 -weighted frame (A, B), with enhancement of the lesion wall and intraluminal flow void after administration of gadolinium (C,D). Exploration of the supra-aortic arteries was normal. No other sources of brain infarction were found on electrocardiogram, transthoracic echocardiography and Holter monitoring. The patient was referred to interventional neuroradiology for endovascular coiling of the aneurysm.

Figure 1: magnetic resonance imaging (MRI) obtained from the referring hospital reported supra-sellar mass, 55 mm in diameter with a crescent shaped hypo-intensity of the lesion wall in the T1-weighted frame and T2 -weighted frame (A, B), with enhancement of the lesion wall and intraluminal flow void after administration of gadolinium (C,D)