The Challenge of a Left Middle Cerebral Artery Bifurcation Aneurysm

A patient's case drew special attention from our neurosurgical team. The patient had a wide-necked cerebral aneurysm located at the bifurcation of the left middle cerebral artery, measuring 3x3 mm. Although asymptomatic, this aneurysm was accidentally discovered during a stroke risk screening using 3D Magnetic Resonance Angiography (3DMRA) of the cerebral vessels.

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Faced with this discovery, the doctor and patient had two treatment options: one was to close the aneurysm internally using a stent or titanium coils; the other was to perform open craniotomy under a microscope, using titanium clips to clamp the aneurysm. After careful discussion and assessment, the doctor and patient decided on open craniotomy. Considering the aneurysm was located at the bifurcation of the middle cerebral artery, choosing endovascular surgery posed a higher risk of occluding normal vessels and causing a stroke.

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The surgery went very smoothly, and the patient's recovery was also excellent, being discharged just two days after the operation. Postoperative MRA comparison showed that the cerebral aneurysm previously located at the left middle cerebral artery bifurcation had disappeared.